Bacillus Calmette‐Guéarin‐treated superficial bladder cancer: Correlation of morphology with immunophenotyping

Publisher Website
Google Scholar
Abstract
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 where frozen tissues were available, Leu 1,2,3,4,14, 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 epithelia were negative.