Lymphocytic infiltrates in primary glioblastomas and recidivous gliomas

Incidence, fate, and relevance to prognosis in 228 operated cases

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✓ The correlation existing in several human malignancies between lymphocytic infiltration and prolonged survival prompted this study. Two hundred selected patients who were operated on for glioblastoma were reviewed to investigate the incidence of the lymphocytic infiltration in the histological slides and its possible relevance to a better clinical course. The group that exhibited a definite lymphocytic infiltration (Group A, 11.5%) had a significantly longer preoperative history and postoperative survival (p < 0.01) than the other two groups that presented slight or no infiltration (Group B, 23%, and Group C, 65%, respectively). In addition, biopsies of 28 recidivous gliomas were reviewed to study the fate of this lymphocytic infiltration in relation to time and therapy, such as irradiation and steroids which are known to depress the immune response. The authors found that severe lymphocytic infiltration is a rare immunobiological reaction which significantly improves the prognosis of a malignant brain tumor and seems not to be influenced by time, local x-ray therapy, or steroids.

Article Information

Address reprint requests to: Lucio Palma, M.D., Istituto di Neurochirurgia, Viale dell'Universita 30, 1–00185, Roma, Italy.

© AANS, except where prohibited by US copyright law.

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Figures

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    Photomicrograph of glioblastoma biopsies. H & E, × 200. Left: A good example of definite lymphocytic infiltration in a glioblastoma. Note the numerous lymphocytes crowded around two small vessels and diffusing between the nearest neoplastic cells. Right: An example of slight lymphocytic infiltration. Two small perivascular cuffs of lymphocytes are apparent. No more than three or four of these cuffs were found in this specimen.

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    Postoperative survival curves of the three groups of patients (see text). The curve for Group A patients is significantly better (p < 0.01) than for the other two groups.

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    Duration of the preoperative history for each of the three groups considered (see text). The curve for Group A patients is significantly better (p < 0.01) than for the other two.

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