Spleen white pulp architecture in the assessment of immunity in patients with far-advanced pancreatic carcinoma.

The histological changes in the white pulp of the spleens collected from 63 patients who had died of widespread adenocarcinoma of the pancreas were assessed by a standardized reporting system. As control material served the same number of age- and sex-matched patients who had died of myocardial infarction without signs of any malignancy. Special attention was focused on the evaluation of the lymphocyte populations (T- and B-cell areas) responsible for immunological reactivity. Histological characteristics suggested to reflect the activity of both cell-mediated and humoral immune responses were within normal limits in the control patients, whereas in the carcinoma series both the T- and B-cell areas were profoundly depleted. The results were interpreted, although with caution, to suggest that some degree of impairment of both humoral and cell-mediated immunity probably exists in patients dying of widespread carcinoma of the pancreas.