Morphology of the spleen white pulp in relation to the immunological functions in patients with far advanced bronchial carcinoma.

The white pulp of the spleens collected from seventy-nine patients died in far advanced bronchial carcinoma, and the same number of spleens from an age-matched group of patients died in myocardial infarction without evidence of any malignancy was histologically assessed by using a standardized reporting system recently introduced by the author. Emphasis was placed on the evaluation of the cell populations involved in immunological reactions. Histological characteristics suggesting an active function of both the cell-mediated and humoral immune reactions (T- and B-cell areas) were found to be within normal limits in the control series, but profoundly deranged in the cancer patients. Active germinal centers were infrequently seen in both series. The significance of the histological observations made was discussed in the light of the impaired immunological reactivity associated with human malignancies, and a conclusion was drawn, although with some caution, that such an impairment of both the humoral and cell-mediated immune responses might probably exist in a considerable number of the present patients dying of far advanced bronchial carcinoma. The applicability of the reporting system now used for the first time in human pathology was emphasized.