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Cytoplasmic inclusions in lymphocytes of chronic lymphocytic leukaemia

A report of 10 cases

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Summary

Peripheral blood from 90 CLL patients was examined by light- and electron-microscopy for the occurrence of crystalline inclusions in lymphocytes. Inclusions were demonstrated in 10 patients (11%). In these patients the inclusions were present in 5–45% of peripheral blood lymphocytes.

In the light microscope the inclusions appeared as rectangular, unstained structures in May-Grünewald Giemsa and PAS stains. In the electron microscope the inclusions appeared as intracytoplasmic, completely partially membrane-bound bodies, which were often associated with dilated profiles of rough endoplasmic reticulum. The ultrastructure of the inclusions was granular.

In immunofluorescence staining the inclusions were found to contain immunoglobulin of the same type and class as the surface membrane-bound immunoglobulin of the neoplastic lymphocytes, most frequently IgMlambda. The lymphocytes of one case with kappa light chains at the cell surface membrane contained inclusions of the same ultrastructural morphology as those of the other cases with lambda light chains.

The presence of inclusions was not associated with any specific clinical or prognostic features. The inclusions persisted during antileukaemic therapy. Their formation may be related to a dysfunction in the synthesis of surface membrane-bound immunoglobulins.

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References

  • Bartoloni C, Flamini G, Gentiloni N, Russo MA, Barone C, Gambassi G, Terranova T (1980) Immunochemical and ultrastructural study of multiple myeloma with a heavy chain protein in the serum. J Clin Pathol 33:936–945

    Google Scholar 

  • Bernard J, Bessis M, Soulier JP, Thiéry JP (1959) Etude au microscope électronique d'une leukémie lymphoide avec cristaux intra-cytoplasmiques. Revue d'Hématologie 3:227–237

    Google Scholar 

  • Binet JL, Leporrier M, Dighiero G, Charron D, D'Athis Ph, Vaugier G, Merle Beral H, Natali JC, Raphael M, Nizet B, Follezou JY (1977) A clinical staging system for chronic lymphocytic leukemia. Cancer 40:855–864

    Google Scholar 

  • Binet JL, Auquier A, Dighiero G, Chastang C, Piquet H, Goasguen J, Vaugier G, Potron G, Colona P, Oberling F, Thomas M, Tchernia G, Jacquillat C, Boivin P, Lesty C, Duault MT, Monconduit M, Belabbes S, Gremy F (1981) A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer 48:198–206

    Google Scholar 

  • Cawley JC, Smith J, Goldstone AH, Emmines J, Hamblin, J, Hough L (1976) IgA and IgM cytoplastic inclusions in a series of cases of chronic lymphocytic leukaemia. Clin Exp Immunol 23:78–82

    Google Scholar 

  • Clark C, Rydell RE, Kaplan ME (1973) Frequent association of IgM λ with crystalline inclusions in chronic lymphatic leukemic lymphocytes. New Eng J Med 289:113–117

    Google Scholar 

  • Feremans WW, Neve P, Caudron M (1978) IgM lambda cytoplasmic crystals in three cases of immunocytoma: a clinical, cytochemical and ultrastructural study. J Clin Pathol 31:250–258

    Google Scholar 

  • Forni L (1979) Reagents for immunofluorescence and their use for studying lymphoid cell products. In: Lefkovits I, Pernis B (eds) Immunological methods. Academic Press, New York, pp 151–167

    Google Scholar 

  • Friedmann I, Michaels L, Bird ES (1971) Crystalline structures in lymphocytes. J Pathol 105:289–293

    Google Scholar 

  • Geisler C, Hansen MM (1981) Chronic lymphocytic leukaemia: A test of a proposed new clinical staging system. Scand J Haematol (in press)

  • Hansen MM (1973) Chronic lymphocytic leukaemia. Clinical studies based on 189 cases followed for a long time. Scand J Haematol (Suppl) 18:80–100

    Google Scholar 

  • Hurez D, Flandrin G, Preud'homme JL, Seligmann M (1972) Unreleased intracellular monoclonal macroglobulin in chronic lymphocytic leukaemia. Clin Exp Immunol 10:223–234

    Google Scholar 

  • Jondal M (1974) Surface markers on human B and T lymphocytes. IV. Distribution of surface markers on resting and blast transformed lymphocytes. Scand J Immunol 3:739–747

    Google Scholar 

  • Laurell C-B (1972) Electronimmunoassay. Scand J Clin Lab Invest (Suppl) 124:21–37

    Google Scholar 

  • Lennert K, Mohri N, Stein H, Kaiserling E, Müller-Hermelink HK (1978) Malignant lymphomas other than Hodgkin's disease. Springer-Verlag Berlin, Heidelberg, New York, pp 209–281

    Google Scholar 

  • Man JCH de, Meiners WBH (1962) Crystals of protein nature in the cytoplasm of lymphocytic cells in a case of lymphoreticular malignancy. Blood 20:492–500

    Google Scholar 

  • Mason DY, Leonard R, Laurent G, Gourdin MF (1980) Immunoperoxidase staining of surface and intracellular immunoglobulin in human neoplastic lymphoid cells. J Clin Pathol 33:609–616

    Google Scholar 

  • McCann SR, Whelan A, Greally J (1978) Intracellular lambda light chain inclusions in chronic lymphocytic leukaemia. Br J Haematol 38:367–371

    Google Scholar 

  • Mennemeyer R, Hammar SP, Cathey WJ (1974) Malignant lymphoma with intracytoplasmic IgM crystalline inclusions. New Engl J Med 291:960–963

    Google Scholar 

  • Preud'homme JL, Seligmann M (1972) Surface bound immunoglobulins as a cell marker in human lymphoproliferative diseases. Blood 40:777–794

    Google Scholar 

  • Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS (1975) Clinical staging of chronic lymphocytic leukaemia. Blood 46:219–234

    Google Scholar 

  • Reynolds EW (1963) The use of lead citrate at high pH as an electron-opaque stain in electron microscopy. J Cell Biol 17:208–213

    Google Scholar 

  • Ritchie RF, Smith R (1976) Immunfixation I. General principles and application to agarose gel electrophoresis. Clin Chem 22:497–499

    Google Scholar 

  • Roberts GH, Gordon J, Smith JL, Newell D, Pike R (1979) The biosynthesis and characterization of IgM λ in a case of chronic lymphocytic leukaemia with intracellular immunoglobulin inclusions. J Clin Pathol 32:272–279

    Google Scholar 

  • Stavem P, Førre Ø (1981) The same type of crystalline inclusions in T-lymphocytes as in plasma cells and B-lymphocytes in multiple myeloma. A pathological clone originating from a common lymphocyte stem cell? Scand J Haematol 26:265–271

    Google Scholar 

  • Stavem P, Vandvik B, Skrede S, Hovig T (1975) Needle-Like crystals in plasma cells in a patient with a plasma cell proliferative disorder. Scand J Haematol 14:24–34

    Google Scholar 

  • Stefani S, Chandra S, Schrek R, Tonaki H, Knopse WH (1977) Endoplasmic reticulum-associated structures in lymphocytes from patients with chronic lymphocytic leukaemia. Blood 50:125–139

    Google Scholar 

  • Valenzuela R, Deodhar SD, Braun WE (1980) Cytoplasmic crystalline structures in lymphoid cells of a human renal allograft. Human Pathology 11:84–85

    Google Scholar 

  • Vernon S, Voet RL, Naeim F, Waisman J (1979) Nodular lymphoma with intracellular immunoglobulin. Cancer 44:1273–1279

    Google Scholar 

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Ralfkiær, E., Hou-Jensen, K., Geisler, C. et al. Cytoplasmic inclusions in lymphocytes of chronic lymphocytic leukaemia. Virchows Arch. A Path. Anat. and Histol. 395, 227–236 (1982). https://doi.org/10.1007/BF00429615

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