Structure of Lymphocytic Series <>) Cells in Relation lo Disease 285 



protein secretions. Protein or glycoprotein secretions may be precipitated as 

 intracytoplasmic colorless or red crystalloids, or they may he present as pale 

 or dark-bine globules or rarely as acidophilic round structures. Such globular 



inclusions, regardless of their staining reactions in imprints or marrow 

 smears, probably correspond to the acidophilic Russell bodies in tissue sec- 

 tions. The finding of red-staining cytoplasmic buds at the periphery of the 

 cell body has elicited the descriptive term "flaming plasma cell." 



Malignant structural features comprise the customary cellular signs of 

 this change and include nuclear and nucleolar gigantism, bizarre nuclear 

 lobulations, and abnormal mitoses. The type of secretion is not helpful in 

 this respect when examined within the cells themselves by ordinary methods. 

 Of more importance for the diagnosis of a malignant plasmacytosis is the 

 finding of predominant plasmablasts and proplasmacytes (Fig. 19-17) with 

 disproportionately small numbers of adtdt plasma cells. In contrast, the re- 

 active plasmacvtoses of antibody formation (e.g.. infection, amyloidosis, 

 rheumatoid arthritis, disseminated lnpns erythematosus) are characterized 

 by the presence of numerous adult Marschalko type plasma cells in the com 

 pany of only small percentages of their immature precursors. It is in such 

 population analyses that imprint studies show their greatest value. 



LYMPHOCYTE FORMATION OF PLASMA CELLS 



The formation of plasma cells by lymphocytes (Fig. 19-18) appears to be 

 accomplished by gradual hypertrophy of the narrow cell body. As the cyto- 

 plasm increases, the basophilia deepens. The nucleus becomes eccentric, and 

 the diffusely coarsened chromatin aggregates into blocks. Concurrently the 

 nonstaining cellular organelles mass into a focal area about the cell center to 

 form an irregularly clear area known as the hof. All transitional stages may 

 be seen in the central cells of Figure 19-18. Experimental evidence in animals 

 demonstrates that lymphocytes are undoubtedly capable of forming plasma 

 cells, but in doing so they first formed macrophages in Campbell and Good's 

 work"' and "transitional" cells in Roberts' experiments (Chapter 7). Ob- 

 viously further studies of imprinted reactive plasmac \toses within the lym- 

 phocytic tissues of man together with simultaneous plasma and cellular 

 protein analyses are indicated. 



SUMMARY 



Cellular descriptions of each of the members of the lymphocytic and 

 plasmacytic series have been given as they appear in imprinted preparations 

 of the lymphocytic tissues, marrow aspirates, and blood smears. These com- 

 prise the inactive reticulum cell, the blood-forming reticulum cell and 

 blasts, and intermediates and resulting adult cells which are formed. 



