Splenic micro-anatomical localization of small lymphocytic lymphoma/chronic lymphocytic leukemia using a novel combined silver nitrate and immunoperoxidase technique

Morris Edelman, Lance Evans, Sui Zee, Ronaldo Gnass, Howard Ratech

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) may be histologically difficult to differentiate from reactive lymphoid hyperplasia (RLH) in the spleen. Because routine hematoxylin and eosin (H and E) staining delineates splenic microanatomy poorly, we have developed a method that simultaneously stains reticulin fibers and B-lymphocytes. B3 or formalin- fixed, paraffin-embedded archival splenic tissue with diagnoses of SLL/CLL (11 cases), RLH (10 cases), and trauma (seven cases) were studied using a novel silver nitrate immunoperoxidase (SNIP) double-staining technique. Gordon and Sweet's reticulin stain was followed by immunoperoxidase staining for B-lineage marker CD20 (Dakopatts, Carpinteria, CA) using the avidin- biotin method. This allowed us to clearly localize B cells to Malpighian bodies, periarteriolar lymphoid sheaths, sinuses, or cords. Features identified by SNIP found only in SLL/CLL, but not in RLH or traumatized spleens, were trabecular infiltration (eight of 11 cases), subendothelial infiltration (seven of 11 cases), and prominent sinus involvement (seven of 11 cases). One or more of these features were seen in 10 of 11 cases of SLL/CLL. Other distinguishing features were the percentage area occupied by B-lymphocytes in each section (SLL/CLL = 74%; RLH = 46%; traumatized spleens = 36%); and mean spleen weight (SLL/CLL = 1.603 g; RLH = 287 g; traumatized spleens =126 g). We have found the SNIP technique to be superior to traditional H and E staining in identifying B cells in the context of splenic microanatomy.

Original languageEnglish (US)
Pages (from-to)445-452
Number of pages8
JournalAmerican Journal of Surgical Pathology
Volume21
Issue number4
DOIs
StatePublished - 1997

Fingerprint

Silver Nitrate
B-Cell Chronic Lymphocytic Leukemia
Immunoenzyme Techniques
Pseudolymphoma
Spleen
B-Lymphocytes
Staining and Labeling
Reticulin
Hematoxylin
Eosine Yellowish-(YS)
Coloring Agents
Avidin
Biotin
Paraffin
Formaldehyde

Keywords

  • Chronic lymphocytic leukemia
  • Immunoperoxidase staining
  • Reticulin stain
  • Small lymphocytic lymphoma
  • Spleen

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Splenic micro-anatomical localization of small lymphocytic lymphoma/chronic lymphocytic leukemia using a novel combined silver nitrate and immunoperoxidase technique. / Edelman, Morris; Evans, Lance; Zee, Sui; Gnass, Ronaldo; Ratech, Howard.

In: American Journal of Surgical Pathology, Vol. 21, No. 4, 1997, p. 445-452.

Research output: Contribution to journalArticle

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abstract = "Small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) may be histologically difficult to differentiate from reactive lymphoid hyperplasia (RLH) in the spleen. Because routine hematoxylin and eosin (H and E) staining delineates splenic microanatomy poorly, we have developed a method that simultaneously stains reticulin fibers and B-lymphocytes. B3 or formalin- fixed, paraffin-embedded archival splenic tissue with diagnoses of SLL/CLL (11 cases), RLH (10 cases), and trauma (seven cases) were studied using a novel silver nitrate immunoperoxidase (SNIP) double-staining technique. Gordon and Sweet's reticulin stain was followed by immunoperoxidase staining for B-lineage marker CD20 (Dakopatts, Carpinteria, CA) using the avidin- biotin method. This allowed us to clearly localize B cells to Malpighian bodies, periarteriolar lymphoid sheaths, sinuses, or cords. Features identified by SNIP found only in SLL/CLL, but not in RLH or traumatized spleens, were trabecular infiltration (eight of 11 cases), subendothelial infiltration (seven of 11 cases), and prominent sinus involvement (seven of 11 cases). One or more of these features were seen in 10 of 11 cases of SLL/CLL. Other distinguishing features were the percentage area occupied by B-lymphocytes in each section (SLL/CLL = 74{\%}; RLH = 46{\%}; traumatized spleens = 36{\%}); and mean spleen weight (SLL/CLL = 1.603 g; RLH = 287 g; traumatized spleens =126 g). We have found the SNIP technique to be superior to traditional H and E staining in identifying B cells in the context of splenic microanatomy.",
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