Immunological reactivity in patients with widespread carcinoma of the liver and bile ducts as evaluated on the basis of spleen white pulp morphology.

The morphology of the white pulp of the spleens collected from forty four patients died in widespread carcinoma of the liver and extrahepatic bile ducts was histologically evaluated by utilizing the standardized reporting system previously outlined. As a control material, the same number of age- and sex-matched patients died in myocardial infarction or cerebrovascular accident without signs of any malignancy was used. Special attention was paid to the assessment of the T- and B-lymphocyte populations responsible for the immunological reactivity. Histological characteristics suggesting an active function of both the cell-mediated and humoral immune reactions (central and peripheral lymphoid sheats, respectively) were found to be within the normal range in the control spleens, whereas in the cancer series, both these elements were profoundly deranged. The significance of the histological observations made was discussed in the light of the tumor immunology, and a conclusion was drawn that an impairment of both the humoral and cell-mediated immune responses must exist in patients dying in widespread hepato-biliary carcinoma. The applicability of the standardized reporting system used was advocated.