Macrophage-histiocyte lysozyme activity in relation to the clinical presentation of Hodgkin's disease. An immunohistochemical study.

The clinical presentation of 71 untreated patients with Hodgkin's disease was studied in relation to immunohistochemically demonstrable lysozyme in the lymph node biopsy material. Sixty-one patients (86%) showed a positive staining reaction of varying degree, while ten (14%) showed no demonstrable lysozyme. The clinical features of lysozyme-positive patients differed markedly from those of lysozyme-negative patients. Stain-positive patients were younger (29 vs. 46), were more often in clinical Stage I or II disease (69% vs. 10%, P less than 0.001), and less frequently had constitutional symptoms (34% vs. 70%, P less than 0.02). Moreover, within the stain-positive group, patients who had the most intense staining reaction (mottling pattern) also had the most favorable clinical and histopathologic features at the time of diagnosis. The observations suggest that in Hodgkin's disease the lysozyme secretory activity of macrophage-histiocytes may be an important element of host resistance to neoplasia and that a depression of this secretory activity corresponds with disseminated disease.