A new disease entity of the lymphoid system has recently been reported by Lukes and Tindle as immunoblastic lymphadenopathy and by Frizzera and associates as angioimmunoblastic lymphadenopathy with dysproteinemia. Reported herein are cytologic, histologic, ultrastructural and immunologic studies of several tissues of a patient with this disorder. In addition to confirming the previous observations that the main cellular constituents in the affected tissue consist of immunoblast, plasmacytoid lymphocytes and plasma cells, the authors have demonstrated a profound deficiency of T lymphocytes in this patient. The previously described amorphous interstitial material appears to represent multiple small cytoplasmic fragments. The histiocytic component, which appears in variable amounts in this disease, in the reported case was very active in phagocytizing cellular and nuclear debris, some of which appeared to be lymphocytic in origin. A rubella infection preceded the onset of the disorder by 3 months.
A group of central nervous system neoplasms, previously known as reticulum cell sarcoma or microglioma, and recently classified as malignant lymphoma, histiocytic type, not infrequently occur in patients with immunodeficiency, either primary or induced by immunosuppressant drugs. The authors report such a neoplasm in a patient with idiopathic thrombocytopenic purpura immunosuppressed with azathioprine and prednisone. The neoplasm was studied with several immunological techniques and by electron microscopy. The neoplasm had B lymphocyte membrane markers and showed plasmacytic differentiation. These features suggest that it was a tumor of transformed B lymphocytes (immunoblasts).
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