Spleen white pulp morphology in the evaluation of the immunological reactivity of patients died in widespread gastric carcinoma.

The histology of the white pulp of the spleens collected from eighty four patients died in widespread carcinoma of the stomach was evaluated by utilizing the standardized reporting system previously outlined by the author. As a control material, the same number of spleens from an age- and sex-matched group of patients died in myocardial infarction or in cerebrovascular catastrophe was assessed. Special emphasis was placed on the alterations of the T- and B-lymphocyte populations involved in immunological reactions of the host. As determined on the grounds of the histology of the central and peripheral periarterial lymphoid sheath, both the cell-mediated and humoral immune responses, respectively, seemed to have preserved their appropriate functions in the control spleens. In the cancer series, on the other hand, the lymphocyte populations responsible for both the humoral and cell-mediated immunity were severely affected. The significance of the findings was discussed in the light of tumor immunology, and a conclusion was drawn that an impairment of both the humoral and cell-mediated immune responses exists in a considerable number of patients at the terminal stage of gastric carcinoma. The applicability of the standardized reporting system used was emphasized, and its acceptance into more general use was advocated.