The clinical, hematologic, and pathologic findings in 26 cases of leukemic reticuloendotheliosis are presented.
A histopathologic correlation of the various forms of leukemia is suggested. Clinically the disease may follow an acute, subacute, or chronic course There is no idiopathic clinical sign or symptom, but the hematologic picture is pathognomonic and is characterized by the presence of reticulum cells in the peripheral blood and bone marrow. These cells are also present in the organs where the reticuloendothelial system predominates: spleen, liver, and lymph nodes.
The study of these cases supports the concept that leukemic reticuloendotheliosis is an independent hematologic and pathologic entity.
The study of blood from rabbits with normal and with hyperactive lymphatic tissue reveals, in the latter, a greater percentage of lymphocytes with heavily basophilic cytoplasm and numerous mitochondria. This indicates that cytoplasmic basophilia and mitochondrial content can serve as criteria of the degree of maturity of the lymphocyte, these characters having the same significance in this relation as obtains with other blood cells. Basophilia is the more evident and reliable indicator of youth of the cells. The classification of lymphocytes into three groups, according to degree of basophilia, has yielded figures which show the proportions of the three to be relatively stable in blood from normal adult human beings and rabbits.
Size is not strictly a function of age in lymphocytes. Moreover, there is no correspondence in the size of lymphocytes in supravital films and in fixed specimens obtained by the "cover glass" method. There is a change of size during fixation. Although lymphocytes of intermediate and large size may be of any age, in supravital preparations the majority are young cells, whereas in fixed films the reverse obtains. The small lymphocyte may be of any age in specimens examined by either technique.
The total number of lymphocytes circulating at any given time is not necessarily an index to lymphoid activity.
It was reported by White in 1928 (1) and confirmed by Sabin, Doan, and Forkner (2, 3) that a polysaccharide isolated from the tubercle bacillus by Anderson (4) was toxic for tuberculous guinea pigs.With doses of 10 mg. the guinea pig either'died within a few hours, in which case there was a precipitous fall in temperature; or it survived and showed only a temporary fall in temperature with subsequent rise above the normal level. There was also a change in the blood cells characterized by a rise in the neutrophilic leucocytes and a fall in lymphocytes.
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