The blood microvasculature in T-cell lymphomas. A morphological, ultrastructural and immunohistochemical study

The microvasculature of lymph nodes of 55 cases of T-cell lymphoma was studied by light microscopy, immunohistochemistry and electron microscopy. A modified peroxidase-antiperoxidase (PAP) method was used for staining paraffin sections with lectin I of Ulex europaeus (UEA-I), which is a specific marker for vascular endothelial cells. The T-cell nature of each case was proven by immunohistochemistry, including immunoperoxidase staining of frozen sections with monoclonal T-cell antibodies. The cases were subclassified according to previously established criteria, but with the addition of a separate group showing a high content of clear cells. For the purpose of the present study, the small blood vessels were separated into two main variants, viz.: high endothelial venules (HEV) and all other types of vessels with flat endothelium (SVFE). The development of each of these variants and the extent of lymphocyte migration through the vascular wall were assessed semiquantitatively. The findings suggest that the blood microvasculature, as a whole, is similar in all types of T-cell lymphoma. There were distinct differences, however, in the development of the two main categories of small vessels between the various types. Chronic lymphocytic leukaemia of T-type (T-CLL) and Sézary's syndrome were poor in SVFE and rich in HEV, and there was considerable lymphocyte traffic through the latter. In contrast, T-immunoblastic and especially T-lymphoblastic lymphocyte traffic. The appearance of the microvasculature varied markedly in the various subtypes of "pleomorphic T-cell lymphoma". In the small cell subtype HEV predominated and SVFE represented only a small or moderate fraction of the microvasculature. As the size of the neoplastic lymphoid cells increased towards the medium-sized and large cell subtype, there was a decrease in the number of HEV and an increase in the number of SVFE accompanied by a decrease in lymphocyte migration. In T-cell lymphoma of the clear cell type the microvasculature showed features between those of T-CLL and the small cell subtype of pleomorphic T-cell lymphoma. Electron microscopy confirmed the light microscopic findings and revealed many similarities in vascular changes between "pleomorphic T-cell lymphomas" and lymphogranulomatosis X.