Structure of Lymphocytic Series of Cells in Relation to Disease 2S1 



type, the chronic lymphocytic leukemias, and most of the lymphomas and 

 Leukemias complicated by Waldenstrom's syndrome. In diagnosis of the cell 

 type in any of these conditions, attention is again directed chiefly to the 

 nuclear chromatin pattern which is heavy and coarse and without evidence 

 of immaturity. Nuclear and cytoplasmic vacuolation is not infrequent. The 

 mature nuclear pattern in any of these conditions may be further compli- 

 cated by bizarre nuclear indentations (Fig. 19-16), a complication which we 

 have described in each succeeding member of heterologous and homologous 



Fig. 19-17. A reticular plasmablast (right) and three- proplasmacytes 

 from bone marrow in multiple myeloma. Leishman stain, (x 1100) 



lymphocyte formation. Even less frequent is the presentation of a large 

 cell-bodied, atypical but mature leukocytoid lymphocyte (see below r ) as the 

 predominant cell type of chronic lymphocytic leukemia. This unusual 

 leukemia would seem to present almost insurmountable difficulties for 

 differentiation from the reactive lymphocytosis of infectious mononucleosis 

 if it were not for the fact that chronic lymphocytic leukemia is almost never 

 found in children and young adults and is additionally lacking in the typical 

 serologic results of the antibody (not absorbed by Forssman antigen but 

 absorbed by bovine red cells) so prevalent in infectious mononucleosis. 



LEUKOCYTOID OR ATYPICAL LYMPHOCYTES 



These characteristically mature but atypical lymphocytes, unlike normal 

 large lymphocytes which in spite of their greater diameter maintain the 



