SUMMARY The peripheral lymphocytes of 50 cases of human immunodeficiency virus (HIV) infection (13 of acquired immune deficiency syndrome (AIDS), 17 of AIDS related complex (ARC), and 20 healthy carriers) were studied immunoultrastructurally. The prevalence of "tubuloreticular structures" and "tubular confronting cisternae" increased with the progression of the disease. Numerous tubular confronting cisternae were noted in patients presenting with a high serum acid labile cx-interferon values. The patients with depressed natural killer cell activity were characterised by circulating immature natural killer cells with abundant multivesicular bodies that were devoid of "parallel tubular arrays". With an immunogold staining technique the location of HIV antigen was detected ultrastructurally, both at the surface of "hand-mirror" natural killer cell lymphocytes and inside vacuolised cells, probably corresponding to infected T4 lymphocytes. These findings indicate the usefulness of electron microscopic techniques in evaluating the pathology and the pathogenetic outcome of AIDS.The existence of ultrastructural markers was first reported in patients with "full-blown" acquired immune deficiency syndrome (AIDS).' We have described similar findings in cases of AIDS from Central Africa.2 Only a few well documented ultrastructural studies on peripheral lymphocytes in AIDS and AIDS related complex (ARC) have been carried out. 5 We previously showed the presence of retroviral antigens by immunogold staining in circulating lymphocytes in prodromal AIDS.6 This study aimed to describe and complement our description by investigating the clinical importance of the ultrastructural abnormalities observed in peripheral blood lymphocytes through different clinical stages of human immunodeficiency virus (HIV) infection. Colloidal gold antibody probes were applied for the identification of the membrane phenotype ofthe abnormal cells and for detecting the ultrastructural location of HIV antigen.
Granulocyte‐macrophage clusters and colony‐forming cells (CFU‐C) in the peripheral blood have been studied in 26 cancer patients with neoplastic bone marrow involvement. The concentration of CFU‐C in the blood of normal individuals and of cancer patients with no bone marrow invasion, ranged from 0 to 99 ml. In contrast, out of 27 cancer patients with marrow invasion, 9 (35%) showed a significant increase of blood CFU‐C (100 to 21000/ml) and of those 5 (19%) showed an increase of blood colonies (41 to 9000/ml). There was a strong correlation between increased CFU‐C or colony concentration and the presence of myeloid or/and erythroid immature cells in the peripheral blood. On the other hand, there was no apparent correlation between an increased CFU‐C level and anaemia or abnormal blood leucocyte count or marrow fibrosis. These observations suggest that bone marrow involvement by neoplastic cells may cause spatial redistribution of the grnulocyte macrophage progenitor cells.
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