Bacillus Calmette-Guérin-treated superficial bladder cancer: correlation of morphology with immunophenotyping.
Thirty-five biopsies from 19 patients with superficial transitional cell carcinoma of the bladder, treated with intravesical bacillus Calmette-Guérin (BCG), were assessed histologically and immunohistochemically. Pretreatment biopsies were available for comparison in all cases and five cases of non-specific cystitis were also examined. The inflammatory infiltrate was assessed with a streptavidin-biotin-peroxidase method using UCHL1, MT1, LN3, L26, HAM56, MAC387, Leu7 and anti-S100 in paraffin sections, and in 18 specimens were frozen tissues were available, Leu1, 2, 3, 4, 14, OKT10, HLA-DR and anti-Tac antibodies were applied. Post-treatment bladder biopsies showed severe oedema and a variable degree of inflammation. A granulomatous inflammation was seen in 11 cases, with granulomas present in six prostatic biopsies and acid-fast bacilli in two cases. The lymphoid infiltrate in all biopsies were largely T lymphocytes with a predominance of T helper cells present, often as a band-like infiltrate pressing against the residual epithelium, or the denuded bladder surface, and distributed in the vicinity of the granulomas. Activated lymphocytes were prominent in seven cases, although a moderate infiltrate of such cells was seen in all instances. Tac antigen was only occasionally expressed, and in a few NK cells were present among the infiltrates. In eight cases, HLA-DR was expressed in epithelial cells following BCG treatment, whereas all pre-treatment epithelial were negative.
Leong
A S
AS
Division of Tissue Pathology, Royal Adelaide Hospital, Adelaide, South Australia.
Wannakrairot
P
P
Jose
J
J
Milios
J
J
D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000276:immunology / Q000628:therapy*; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology*; D014375:Tuberculoma / Q000473:pathology; D001743:Urinary Bladder / Q000473:pathology; D001745:Urinary Bladder Diseases / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*
D001500:BCG Vaccine