Primary lymphomas of the small intestine in Egyptian patients: an immunologic study

The cytoplasmic immunoglobulin profile was determined for 25 cases of primary lymphomas of small intestine using an ABC immune peroxidase system on paraffin sections. Fifteen cases were positive for alpha heavy chain [9 of them were also negative for Kappa and Lambda light chains and 6 were positive for kappa and lambda]. The histologic and immunologic features varied according to the site of the tumor in the small intestine. Thus, in the 13 cases arising in the jejunum, 12 were positive for alpha-heavy chain. The histologic picture of these jejunal tumors were 10 diffuse large cleaved and non-cleaved and 3 cases were immunoblastic. Conversely, in the other 12 cases arising from the ileum, only 3 were positive for alpha-heavy chain reaction [all were also +ve for light chain reaction]. Histologically, the ileal tumors included 9 small non-cleaved, one immunoblast lymphoma, one mixed, and one large non-cleaved lymphoma. All 9 cases of small non-cleaved lymphomas were negative for alpha-heavy chain as well as light chain reactions. Thus, the diagnostic criteria of Mediterranean lymphoma [IPSID] must include clinical history of malabsorption, tumor site at proximal part of small intestine and large cell type histology. However, the alpha-heavy chain parameter appears to be variable and nonspecific