262 The Lymphocyte and Lymphocytic Tissue 



an asterisk in Table 19-1 or again that the mixed type itself may be nodular 

 or diffuse in growth pattern. We agree that lymphomas with a nodular 

 pattern should be integrated into the general classification of malignant 

 lymphomas by using any one of the accepted cytologic classifications for 

 each lymphoma and adding the term "nodular" or "follicular" whenever 

 this is indicated by the prevailing architectural pattern. In this way the 

 prognosis as to longevity can be correlated not only as to cellular composi- 

 tion and cellular differentiation but also within each cellular group as to 

 the presence or absence of the generally more favorable nodular or follicular 

 pattern of growth. The reader should have access to descriptions of the 

 histologic architecture of the lesions of Hodgkin's disease in the excellent 

 and detailed publication of Jackson and Parker. 80 Somewhat divergent 

 views from abroad may be examined in the texts of Lumb, 38 Marshall, 30 

 Moeschlin, 40 and Bessis 4 in respect to the entire field of the lymphomas and 

 related leukemias. 



Usually the histologic pattern of the lesions of the lymphocytic tissues 

 is sufficient to establish their benign or malignant nature whereas the air- 

 dried imprints of the same lesions, stained like blood smears, are often 

 needed for accurate identification of predominant cell types. In this supple- 

 mental fashion the use of imprints after study of the sections is advantageous 

 and often necessary. Berman 3 cautions, and it should be repeated, that im- 

 prints alone are usually inadequate for establishing whether or not a lesion 

 is malignant unless bizarre and malignant cells are predominant because 

 many of the individual cells seen in imprints from neoplastic lesions are 

 also present in reactive or even normal lymphocytic tissues. Downey and his 

 associates 33 - 55 were the first in this country to popularize the use of imprints 

 of hematopoietic tissues to gain the more precise information to be obtained 

 by inspection of air-dried films, information which is so readily correlated 

 with the great amount of information already accumulated for bone marrow 

 and blood cells by classic hematologic methods. There is a growing literature 

 on the utilization of the imprint technic as an adjunct in the study of lym- 

 phocytogenesis and neoplasms of lymphocytic tissues. 2 ' 3 - 3333, 40 - 43, 46, 5355, 



57-59 



It is the purpose of this chapter to describe the principal cells of the lym- 

 phocytic tissues as seen in air-dried preparations of imprints or smears and 

 the disturbances to which they fall prey. As far as is applicable, recommenda- 

 tions of the committee for clarification of nomenclature of the blood and 

 blood-forming organs will be utilized. 7 In 1912 Downey and Weidenreich 18 

 crystallized evidence that the reticuloendothelial (RE) cells (reticulum cells, 

 mesenchymal cells, histiocytic system of cells) were the mother tissue cells for 

 the lymphocytes. The inactive RE cell depicted in Figure 19-1 has many 



