[Congenital dyserythropoiesis: an unclassifiable case?].
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Biomedical subjects
Publications and source records attributed to M Reynes.
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The term immunoblast created by Dameshek, is useful in routine cytological and histopathological practice, for the diagnosis of lymphadenites and malignant blood diseases. This term designates a group of cells, the appearance of which is quite different from other cells of the lymphoid tissue. Their morphological characteristics are precise and they resemble transformed lymphocytes. These immunoblasts are derived from T and B lymphocytes. Using purely morphological methods the type B of certain immunoblasts may be suggested. Immunoblasts of the clear centers of follicles, immunoblasts undergoing plasma cell transformation, tumour cells constituting nodular immunoblastosarcomas, immunoblasts appearing in the tumor population of the myelomas and of Waldenström's macroglobulinaemia. The term immunoblast which evokes precise morphological criteria, should be maintained. This term cannot designate only B lymphocytes, but also transformed lymphocytes of type B or T.
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This report describes the ultrastructural characteristics of a Poncet-Spiegler tumor (cylindroma, turban tumor). This tumor was made up of two cell types and showed a ductal differentiation. Cells bordering duct-like structures were joined together by innumerable desmosomes, especially in places where the cell membranes were markedly invaginated. The arguments in favor of an eccrine or an apocrine for the origin of this sweat gland tumor are discussed.
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The authors describe the various cytological and pathological lesions found in lymph node, spleen, bone marrow and liver in Waldenströms macroglobulinemia. The significance of the discovery of PAS positive intranuclear vacuoles is discussed. The findings are completed by a description of the results obtained in immunofluorescence and under the electron microscope. Unusual forms and the differential pathological diagnosis are then discussed.
Four cases of sarcomatous or leukaemic types of Waldenström's macroglobulinemia are presented. They are characterized by tumoral and compressive localizations of lymph node or spleen, or by a hyper-leukocytosis with many circulating abnormal cells. These cells are different from the lympho-plasma cells regularly observed in Waldenström's macroglobulinemia, and can be assimilated to malignant immunoblasts. They have a proliferative aspect and seem to produce less macroglobulin and to recover some beta-glucuronidase activity. The sarcomatous and leukemic types of Waldenström's macroglobullinemia have a poor prognosis and may appear as terminal transformation of the disease.
The authors report 79 needle biopsies of the liver, using a Menghini needle, carried out as routine in untreated cases of pulmonary tuberculosis with positive sputum. Apart from the histological study, the authors carried out, in 30 cases, a bacteriological study of the liver fragment. The bacteriological and histological results are reported here in detail, then compared with those in the world literature. No significant correlation was found between the histological type of the suggestive hepatic lesions, e.g. follicular appearances or appearances of nodular küpferian hyperplasia and the radioclinical variety of pulmonary tuberculosis, e.g. parenchymatous, pleural or miliary. The authors emphasize the significance of each type of pathological lesion encountered, in particular, the appearance of nodular küpferian hyperplasia or intralobular, lymphohistiocytic islets, which seem to them remarkable by their relative frequency and their chararacter fairly suggestive of tuberculosis. In spite of the low number of pathological appearances obtained in these liver biopsies, the present study nevertheless permitted a few interesting conclusions on the blood spread of the tubercle bacillus and the significance of changes in the Küpfer system during common pulmonary tuberculosis.
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