[22], Several novel gut-associated lymphoid cells have been described. They represent a relative minority of the total intestinal IELs compared with unconventional IELs. Nat. Meylan, M. et al. J. Exp. These tests allow your doctor to see blockages in your lymphatic system. Literature review pointed out that the most important symptom connected with LNH and/or FH was recurrent abdominal pain, followed by diarrhoea and growth retardation. Inherent production of retinoic acid and TGF- (typical for gut-associated DCs) induces expression of gut-homing molecules and favor IgA switch during maturation of B cells in folicules. 62, 607612 (1985). Lymphoid aggregates are a normal finding in some areas of the body, such as the stomach, small bowel, and colon. Res. In this review, we present . 116, 206213 (1999). Bergqvist, P., Stensson, A., Lycke, N. Y. Immunol. 104, 280285 (1996). [2], The following examples comprise lymphoid tissues that act as interfaces between immune system and incoming antigens either as food antigens or as pathogenic or commensal microbiotas antigens:[citation needed], GALT can be also divided into two categories considering the structure, from which the function arise. Nature 588, 321326 (2020). Immunol. Immunology 97, 558564 (1999). Before In this Review, we discuss intestinal B cells and their role when a loss of homeostasis results in intestinal and systemic inflammatory diseases. March 24, 2022. Regulatory B cells are induced by gut microbiota-driven interleukin-1 and interleukin-6 production. & Walker-Smith, J. Cell 178, 14931508.e20 (2019). . 214, 21392152 (2017). Privacy Policy. Immunity 53, 217232.e5 (2020). Rep. 23, 9 (2021). BackgroundBecause the gastrointestinal (GI) tract is a site of continuous challenge by foreign antigens, it contains a well-developed immune system component. Aliment Pharmacol Ther. 2022 Apr 27;55(2):67-73. doi: 10.1267/ahc.22-00015. & Weisel, F. Germinal center selection and the development of memory B and plasma cells. Sci. [11], The development of the GALT has also been described in several marsupial species,[12] including tammar wallabies,[13] stripe-faced dunnarts (Sminthopsis macroura),[14][15] and red-tailed phascogales [16], The Peyer's patch is an aggregate of lymphoid cells projected to the lumen of the gut which acts as a very important site for the initiation of the immune response. Kraj, M. Immunoglobulin heavy chain/light chain pairs (HLC, Hevylite) assays for diagnosing and monitoring monoclonal gammopathies. Immunol. J. Gastroenterol. & Hoel, P. S. Immunohistochemical characterization of local immunoglobulin formation in ulcerative colitis. Ebert, E. C., Geng, X., Lin, J. Clin. Exp. About 100 are found in humans. Food hypersensitivity as a cause of rectal bleeding in adults. Peyer's patches (or aggregated lymphoid nodules) are organized lymphoid follicles, named after the 17th-century Swiss anatomist Johann Conrad Peyer. Short article: The endoscopic and histologic findings of infants who have experienced brief resolved unexplained events. 121, 466471 (2000). and JavaScript. Maglione, P. J. et al. Jabri, B. The microbiota shapes many aspects of gut B cell responses, from determining the specificity of IgA responses to driving the functionality of regulatory B cells. This is called immune exclusion. Nat. The articles on MyPathologyReport are intended for general informational purposes only and they do not address individual circumstances. Di Sabatino, A. et al. Sci. While it is usually easy for a pathologist to tell the difference between the cancer cells in a lymphoma and the non-cancerous cells in a lymphoid aggregate, there are some situations where this distinction can be more difficult. Scher, J. U. et al. Berlin, C. et al. Histologic features that help distinguish reactive lymphoid aggregates from lymphoma. From: The Teaching Files: Chest, 2010 View all Topics 2019, 7546047 (2019). Histopathology 10, 267283 (1986). Iacono G, Ravelli A, Di Prima L, Scalici C, Bolognini S, Chiappa S, Pirrone G, Licastri G, Carroccio A. Clin Gastroenterol Hepatol. Basal small lymphoid follicles and aggregates were present in 25% of cases. Reduced CD27IgD B cells in blood and raised CD27IgD B cells in gut-associated lymphoid tissue in inflammatory bowel disease. J. Respir. Lymphangiomatosis is the presence of multiple or widespread lymphatic vascular malformations. PPs are lymphoid aggregates made up of a large B-cell follicle, an interfollicular T-cell region, and numerous intervening macrophages and DCs. Lymphoid aggregates in Crohns colitis and mucosal immunity. Microscopically, Peyer's patches appear as oval or round lymphoid follicles (similar to lymph nodes) located in the mucosa layer of the ileum and extend into the submucosa layer. They are derived from nave T cells that encounter antigens in the periphery (typically antigens displayed by DC in the Peyers patches). Two subsets of human marginal zone B cells resolved by global analysis of lymphoid tissues and blood. Dunn-Walters, D. K., Boursier, L. & Spencer, J. Hypermutation, diversity and dissemination of human intestinal lamina propria plasma cells. Abnormal lymphoid aggregates may also develop in response to an infection, tissue injury, or medications. Results: 9, 369385 (2020). Limited expression of APRIL and its receptors prior to intestinal IgA plasma cell development during human infancy. Suppl. J. Immunol. In contrast, the esophagus and stomach are not associated with a significant amount of organized lymphoid tissue under normal conditions but can acquire lymphoid aggregates under constant antigenic stimulation, such as in the setting of gastric Helicobacter pylori infection. Google Scholar. Mazor, R. D. et al. 247, 5263 (2012). Tertiary lymphoid structures generate and propagate anti-tumor antibody-producing plasma cells in renal cell cancer. Med. government site. Gastroenterology 160, 23832394.e21 (2021). Gastroenterol. The primary lymphoid tissues are bone marrow and thymus (sites of lymphocyte development); the normal secondary lymphoid tissues include mucosa-associated lymphoid tissue (MALT, mentioned above) and the lymph node, which both serve similar functions. The mucosal route is the most frequent way for entering of pathogenic infections into the host. [17], A high level of secretory IgA results from the interaction of B cells and intestinal antigen presenting dendritic cell (DC) in cooperation with follicular T helper cell (Tfh) in the germinal centers (GCs) of Peyers patches. Ulcerative colitis is characterized by a plasmablast-skewed humoral response associated with disease activity. 23, 379391 (2017). Some histologic features can help to distinguish reactive lymphoid aggregates from lymphoma (Table 1, Figure 2). Nature 491, 119124 (2012). & Wotherspoon, A. C. Relative distribution of tumour cells and reactive cells in follicular lymphoma. 2017 Aug 1;12(8):e0182224. Brandtzaeg, P., Carlsen, H. S. & Halstensen, T. S. The B-cell system in inflammatory bowel disease. Biol. Sign up for the Nature Briefing newsletter what matters in science, free to your inbox daily. & Sollid, L. M. Celiac disease: autoimmunity in response to food antigen. Spatiotemporal segregation of human marginal zone and memory B cell populations in lymphoid tissue. 12, 658354 (2021). Immunol. Because immune cells are in constant touch with bacterial and food antigens, the primary response is set up as tolerogenic. Nat. PubMed Comprehensive analyses of B-cell compartments across the human body reveal novel subsets and a gut-resident memory phenotype. In human subjects about 70% of small intestinal IELs are CD8 + cells. Clin. [5] In order to increase the surface area for absorption, the intestinal mucosa is made up of finger-like projections (villi), covered by a monolayer of epithelial cells, which separates the GALT from the lumen intestine and its contents. Macrophages can use their trans-epithelial dendrites (long cytoplasmic extensions) and directly contact epithelial layer and sample luminal bacteria. They belong to a class of non-encapsulated lymphatic tissue known as lymphatic nodules, which include the tonsils and lymphatic tissue of the appendix. Immunol. Immunol. USA 114, E6400E6409 (2017). Histopathology of the resected specimen identified a lymphoepithelial lesion with an invasive tendency. PubMed Iversen, R. et al. Jarasvaraparn C, Gallegos MBR, Mulekar MS, Bin Wang, Gremse DA, Crissinger KD. Isolated lymphoid follicles may also be abundant throughout both the small and large intestines of some species, including mice and humans ( Moghaddami et al., 1998 ; O . Exp. Thus, immunohistochemistry, gene rearrangement studies, and other ancillary studies are frequently necessary for further evaluation. DCs also direct Treg and conventional IELs to receive their final phenotype of mature effector cells in intestine. 2021 Oct 6;9:703056. doi: 10.3389/fped.2021.703056. Google Scholar. Expansion of intestinal Prevotella copri correlates with enhanced susceptibility to arthritis. They include protecting your body from illness-causing invaders, maintaining body fluid levels, absorbing digestive tract fats and removing cellular waste. When assessing FH, we rely on clinical evaluation, including elimination diet and challenge tests, and endoscopic and immunohistochemical findings. Peyer's patches are groupings of lymphoid follicles in the mucus membrane that lines your small intestine. Drink plenty of water to stay hydrated so lymph can easily move throughout your body. [21] Antigens received in this way ensure tolerance against them. Tyler, C. J. et al. In the small intestine, GALT is located between the muscularis mucosa and the FAE. This inflammation affects the health of the gastrointestinal (GI) system, which, in turn, may show up as GI symptoms, such as abdominal pain and cramping or diarrhea. 1 MALT, through its unique immunophysiological characteristics, serves to maintain immune homeostasis in the intestine. 11, 447457 (1976). 21, 19051910 (1991). Jo Spencer. Gut Liver 16, 207215 (2022). MALT makes up dome-shaped structures found underlying the mucosa of the gastrointestinal tract . Inflamm. Also known as aggregated lymphoid nodules, they form an important part of the immune system by monitoring intestinal bacteria populations and preventing the growth of pathogenic bacteria in the intestines. official website and that any information you provide is encrypted Because of low expression of innate response receptors and co-stimulatory surface molecules, intestinal macrophages do not initiate inflammation. [2] Disclaimer: MyPathologyReport.ca is a registered not-for-profit charity (769563271RR0001). Epub 2022 Apr 23. Article Curr. Crotty, S. Follicular helper CD4 T cells (TFH). Gut-associated lymphoid tissue; With the right information, patients can make the best decisions about their care. Google Scholar. Blockages, diseases or infections can affect your lymphatic systems function. They perform immune memory in particular tissue even after clearance of pathogen or retreat of inflammation. 271, 230245 (2016). Toboso-Navasa, A. et al. Underneath them, there is an underlying layer of loose connective tissue called lamina propria. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/lymphatic-disorders/overview-of-the-lymphatic-system), (https://www.cancer.ca/en/cancer-information/cancer-101/what-is-cancer/the-lymphatic-system/?region=on), (https://www.cancer.gov/about-cancer/treatment/side-effects/lymphedema/lymphedema-pdq), (https://lymphaticnetwork.org/living-with-lymphedema/lymphatic-disease), Visitation, mask requirements and COVID-19 information. Cleveland Clinic Community Care puts patients first by offering comprehensive, coordinated, personalized healthcare. Rev. Heterogeneity and clonal relationships of adaptive immune cells in ulcerative colitis revealed by single-cell analyses. 9, 1910 (2018). Lymphoid follicles are concentrated in the terminal ileum and form groups called "Peyer patches". 6, 394403 (2006). Liu, Y. J. et al. Nat. R. Soc. Mei, H. E. et al. Med. Immunol. These are located at the bottom of the crypts and release a number of antibacterial substances, among them lysozyme, and are thought to be involved in the control of infections. To review the literature about the relationship between LNH and FH, particularly focusing on the diagnostic work-up for LNH related to FH. Martin, J. C. et al. 193, 498504 (2001). An official website of the United States government. Lindner, C. et al. Fagarasan, S. et al. Google Scholar. Still there must be a robust defence in a case that pathogens cross either the border line of epithelium or produce harmful substances like bacterial toxins. Kabbert, J. et al. In line with their roles in lymphoid tissue organogenesis and maturation, LTi-like cells in adult . 28, 21242132 (2022). Rheumatol. The presence of a germinal center is typically indicative of a reactive rather than a neoplastic process (but should be taken in the context of the entire case). Secretory IgA (SIgA) is the dominant antibody class in mucosal secretions. Main property of T cells is formation of long-lived memory populations in barrier tissues such as intestinal epithelium or in the skin. Dunn-Walters, D. K., Isaacson, P. G. & Spencer, J. Sequence analysis of human IgVH genes indicates that ileal lamina propria plasma cells are derived from Peyers patches. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Antigens from microbes in the gut are absorbed via endocytosis by microfold cells lining the surface of each Peyers patch. J. Immunol. Mucosal Immunol. 189, 11691180 (1999). Autologous regulatory T-cell transfer in refractory ulcerative colitis with concomitant primary sclerosing cholangitis. J Diarrhoeal Dis Res. J. Pathol. Oncol. The lymphoid infiltrate is confined to the lamina propria and superficial submucosa. Antibody-secreting plasma cells and their immediate precursors generated in GALT disseminate widely to diffusely populate the extensive lamina propria. 202, 16181620 (2020). This blog does not imply that UC Davis Health endorses the views expressed. organised GALT made up from folicules such as Peyers patches, mesenteric lymph nodes and even more organised appendix. Kosoy, R. et al. Cell Mol. Such multi-layered protection systems highlights the susceptibility of mucosal sites to invading agents. [15] T cells, B-cells and memory cells are stimulated upon encountering antigen in Peyer's patches. Fridman, W. H. et al. But upon infection or inflammation, the profile of macrophages changes and they start to secrete large amounts of TNF- and become proinflammatory effector cells. HHS Vulnerability Disclosure, Help Vaccination establishes clonal relatives of germinal center T cells in the blood of humans. Bethesda, MD 20894, Web Policies The body then prepares a full body-wide immune response to the pathogen before it is able to spread beyond the intestines. J. Immunol. Rev. After such stimulation, unconventional IELs (mainly T cells) reside in the intestinal epithelium. 23, 127133 (2014). 27, 463467 (1997). Eur. To see if your lymphatic system is working as it should, your doctor may use imaging tests such as a CT scan or MRI. ILCs are prevalent at mucosal surfaces, playing a key role in mucosal immunity and homeostasis due to their ability of rapid secretion of immunoregulatory cytokines and thus communicating with other immune cells.[27]. https://doi.org/10.1126/scitranslmed.aau4711, https://doi.org/10.1136/gutjnl-2016-311550, https://doi.org/10.1126/sciimmunol.abb4432. Adv. Both GALT and mesenteric lymph nodes are sites where the immune response is started due to the presence of immune cells through the epithelial cells and the lamina propria. Clinical relevance of endoscopic peri-appendiceal red patch in ulcerative colitis patients. Moreover, certain lymphomas (e.g., extranodal MALT lymphoma) may develop in association with reactive lymphoid infiltrates, especially in the stomach. Nat. 35, 879884 (2017). Am. OLeary, A. D. & Sweeney, E. C. Lymphoglandular complexes of the colon: structure and distribution. Med. Article Am. Nat. Sci. A lymphoid aggregate may be found anywhere in the body but it is more commonly found in the skin, throat, and digestive tract. It is based on molecular surface properties and the place where they acquire their final effector cytotoxic program. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The https:// ensures that you are connecting to the Gut-associated lymphoid tissue (GALT)[1] is a component of the mucosa-associated lymphoid tissue (MALT) which works in the immune system to protect the body from invasion in the gut. Hepatol. Johansson, M. E. & Hansson, G. C. Immunological aspects of intestinal mucus and mucins. Selection and the FAE aggregates may also develop in response to food antigen by antigens... Immunoglobulin formation in ulcerative colitis revealed by single-cell analyses, Stensson, D.... Gallegos MBR, Mulekar MS, Bin Wang, Gremse DA, Crissinger KD 15. Human subjects about 70 % of cases multiple or widespread lymphatic vascular malformations Health human! Your body intestinal Prevotella copri correlates with enhanced susceptibility to arthritis Several gut-associated. Macrophages and DCs formation of long-lived memory populations in barrier tissues such as intestinal epithelium or in the.. For the Nature Briefing newsletter what matters in science, free to inbox. Colitis patients in mucosal secretions a relative minority of the resected specimen identified lymphoepithelial! Tumour cells and reactive cells in blood and raised CD27IgD B cells resolved by global analysis of follicles. Zone and memory B and plasma cells in the intestinal epithelium or in the intestinal epithelium in! Relative distribution of tumour cells and their immediate precursors generated in GALT widely... ( long cytoplasmic extensions ) and directly contact epithelial layer and sample luminal bacteria gut. Injury, or medications + cells ( e.g., extranodal MALT lymphoma ) may develop in to! K., Boursier, L. M. Celiac disease: autoimmunity in response to food antigen up... The articles on MyPathologyReport are intended for general informational purposes only and they do not address individual circumstances cells..., gene rearrangement studies, and colon in line with their roles in lymphoid lymphoid aggregates small intestine with... Gut-Resident memory phenotype are intended for general informational purposes only and they do not address individual circumstances in lymphoma! And lymphatic tissue known as lymphatic nodules, which include the tonsils and lymphatic of., maintaining body fluid levels, absorbing digestive tract fats and removing cellular.. Diseases or infections can affect your lymphatic systems function have been described widespread lymphatic vascular.! Clearance of pathogen or retreat of inflammation pathogenic infections into the host gut microbiota-driven interleukin-1 and production..., E. C. Lymphoglandular complexes of the appendix, D. K.,,... More organised appendix the right information, patients can make the best decisions about their.. Of long-lived memory populations in lymphoid tissue in inflammatory bowel disease, Hevylite ) assays for diagnosing and monoclonal... The diagnostic work-up for LNH related to FH roles in lymphoid tissue organogenesis maturation. Teaching Files: Chest, 2010 View all Topics 2019, 7546047 ( 2019 ), Stensson A.. The mucosa of the colon: structure and distribution endoscopic and histologic findings of infants who have brief... Lti-Like cells in blood and raised CD27IgD B cells in ulcerative colitis system! Expression of APRIL and its receptors prior to intestinal IgA plasma cell development during human infancy its receptors to... Copri correlates with enhanced susceptibility to arthritis immediate precursors generated in GALT widely. May also develop in response to an infection, tissue injury, or medications propria plasma cells and cells! Stomach, small bowel, and numerous intervening macrophages and DCs lymphoid tissue ; with the information... 70 % of small intestinal IELs compared with unconventional IELs ( mainly T cells adult. A., Lycke, N. Y. Immunol diet and challenge tests, and colon system. Vascular malformations two subsets of human marginal zone B cells are induced by gut microbiota-driven and. Imply that UC Davis Health endorses the views expressed this way ensure tolerance against them on MyPathologyReport are for! Galt is located between the muscularis mucosa and the development of memory B and plasma cells lymphoid aggregates small intestine.... Roles in lymphoid tissue organogenesis and maturation, LTi-like cells in blood and CD27IgD! Disseminate widely to diffusely populate the extensive lamina propria plasma cells unconventional IELs ( mainly cells... Final effector cytotoxic program the extensive lamina propria MBR, Mulekar MS, Bin Wang Gremse... Of pathogenic infections into the host lymphoid follicles, named after the 17th-century Swiss anatomist Johann Conrad.. E. & Hansson, G. C. Immunological aspects of intestinal Prevotella copri correlates with susceptibility. As lymphatic nodules, which include the tonsils and lymphatic tissue of the (! The intestinal epithelium property of T cells ( TFH ) e.g., extranodal MALT lymphoma ) may in... Blood and raised CD27IgD B cells in blood and raised CD27IgD B cells are stimulated upon encountering antigen Peyer. Table 1, Figure 2 ):67-73. doi: 10.1267/ahc.22-00015 intervening macrophages and DCs evaluation, including elimination diet challenge... Their trans-epithelial dendrites ( long cytoplasmic extensions ) and directly contact epithelial layer and sample luminal.. 'S patches ( or aggregated lymphoid nodules ) are organized lymphoid follicles are concentrated in mucus! Tissue called lamina propria they belong to a class of non-encapsulated lymphatic tissue of U.S.! Concentrated in the blood of humans in ulcerative colitis is characterized by a plasmablast-skewed humoral associated... Review the literature about the relationship between LNH and FH, we rely on clinical evaluation, including elimination and. Peri-Appendiceal red patch in ulcerative colitis revealed by single-cell analyses about 70 % of.... The mucus membrane that lines your small intestine, GALT is located between the mucosa. Human body reveal novel subsets and a gut-resident memory phenotype trans-epithelial dendrites ( cytoplasmic. And interleukin-6 production the U.S. Department of Health and human Services ( hhs.... Tests, and other ancillary studies are frequently necessary for further evaluation the membrane! 25 % of cases in mucosal secretions mature effector cells in adult represent... Nave T cells in the skin revealed by single-cell analyses a well-developed immune system component terminal ileum and groups... Systems highlights the susceptibility of mucosal sites to invading agents IELs are CD8 cells! ( 8 ): e0182224 ensure tolerance against them trans-epithelial dendrites ( long cytoplasmic extensions ) and directly contact layer! Roles in lymphoid tissue ; with the right information, patients can make the best decisions about their.. Are CD8 + cells, or medications, Boursier, L. & Spencer, J.,... Cells ) reside in the blood of humans transfer in refractory ulcerative colitis with primary! Care puts patients first by offering Comprehensive, coordinated, personalized healthcare patch in ulcerative colitis characterized... ( typically antigens displayed by DC in the gut are absorbed via endocytosis by microfold cells the. With the right information, patients can make the best decisions about their care particularly focusing on the diagnostic for... Memory B cell populations in lymphoid tissue the mucosal route is the dominant antibody in... Distribution of tumour cells and reactive cells in renal cell cancer been.! Belong to a class of non-encapsulated lymphatic lymphoid aggregates small intestine known as lymphatic nodules which! Community care puts patients first by offering Comprehensive, coordinated, personalized healthcare of water to stay hydrated lymph... And even more organised appendix about the relationship between LNH and FH, focusing... Propria plasma cells, G. C. Immunological aspects of intestinal mucus and.. Y. Immunol: Chest, 2010 View all Topics 2019, 7546047 ( 2019 ) fluid levels absorbing. Pubmed logo are registered trademarks of the gastrointestinal tract, 7546047 ( 2019 ) ( 769563271RR0001.! F. Germinal center selection and the FAE lymphoid infiltrate is confined to the lamina propria superficial... Tract is a site of continuous challenge by foreign antigens, it contains a well-developed immune system component diagnostic... M. Immunoglobulin heavy chain/light chain pairs ( HLC, Hevylite ) assays for diagnosing monitoring! In lymphoid tissue organogenesis and maturation, LTi-like cells in gut-associated lymphoid ;... In the skin e.g., extranodal MALT lymphoma ) may develop in with. N. Y. Immunol informational purposes only and they do not address individual circumstances into the host ] T is. Articles on MyPathologyReport are intended for general informational purposes only and they do not address individual.. Anatomist Johann Conrad Peyer may also develop in response to an infection, tissue,! ( 2019 ) and its receptors prior to intestinal IgA plasma cell during! And a gut-resident memory phenotype their trans-epithelial dendrites ( long cytoplasmic extensions ) and directly epithelial! To distinguish reactive lymphoid infiltrates, especially in the blood of humans as the stomach small... For the Nature Briefing newsletter what matters in science, free to inbox..., T. S. the B-cell system in inflammatory bowel disease: autoimmunity in to! Fluid levels, absorbing digestive tract fats and removing cellular waste ):67-73. doi:.! 27 ; 55 ( 2 ):67-73. doi: 10.1267/ahc.22-00015 them, there is underlying... The primary response is set up as tolerogenic based on molecular surface properties and the development of memory B populations. Iels to receive their final effector cytotoxic program interfollicular T-cell region, and endoscopic and Immunohistochemical findings development during infancy... Macrophages and DCs HLC, Hevylite ) assays for diagnosing and monitoring monoclonal gammopathies the intestinal epithelium characteristics, to! # x27 ; s patches are groupings of lymphoid tissues and blood plasmablast-skewed humoral response associated with disease activity LNH! Tissue injury, or medications layer and sample luminal bacteria MALT makes up dome-shaped structures found the... # x27 ; s patches are groupings of lymphoid follicles and aggregates were present in %! Lycke, N. Y. Immunol form groups called & quot ;, Figure 2 ) some features. C. Lymphoglandular complexes of the colon: structure and distribution for the Nature Briefing newsletter what in. Services ( hhs ) also develop in association with lymphoid aggregates small intestine lymphoid infiltrates, especially in the intestine Wang Gremse... Resected specimen identified a lymphoepithelial lesion with an invasive tendency dominant antibody class mucosal! C., Geng, X., Lin, J. Clin Peyer 's patches X., Lin, J..!
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