Structure of Lymphocytic Series of Cells in Relation to Disease 269 



Megakaryocytes of comparable size and development will be found in the 

 imprinted lesions of myeloid metaplasia and granulocytic leukemia. They 

 may be distinguished readily from Reed-Sternberg cells by the heavy, coarse 

 chromatin pattern possessed by the polymorphous, adult megakaryocytic 

 nucleus. Furthermore, the megakaryocytic cytoplasm presents a dense azuro- 

 philic granulation either spread diffusely throughout the cell body or in 

 multiple focal aggregates prior to imminent platelet formation. 48 Finally, 

 Fisher and Hazard- 4 have shown that megakaryocytic cytoplasm is strongly 

 positive for the periodic acid-Schiff method in contrast to the Reed-Stern- 

 berg" cell. 



The cell at the top of Figure 19-5 is an endothelial cell with its elliptical, 

 finely stippled nucleus and spindle-shaped, elongated cell body. 



Pleomorphic, giant multinucleated or polymorphous malignant reticulum 

 cells are occasionally a feature of the lesions of reticulum cells sarcoma 

 and frequently are present in imprints of lymph nodes in Letterer-Siwe's 

 disease, the third member of this series (Table 19-1). Although suggestive 

 of Reed-Sternberg cells, thev never attain the complete characteristics so 

 well described by Reed 4 " in her 1902 paper, a paper which merits reread- 

 ing. 



A fourth member of this series is E wing's tumor of bone. Figure 19-6 

 depicts the reticulum-like cells of this condition which Avere metastatic from 

 the clavicle of a 14-year-old boy to a regional node and from there im- 

 printed. Fwing- 1 suggested the "perivascular endothelium" as the cellular 

 origin of his tumor. Oberling and Raileanu 41 and Stout r,,; prefer to desig- 

 nate this tumor as a variant of reticulum cell sarcoma on the basis of the 

 demonstration of reticulum cells as integral parts of them. Jaffe 31 agrees 

 to these latter interpretations, sensibly suggesting that the name "E wing's 

 tumor" be retained, however, so that its distinction from primary reticulum 

 cell sarcoma may be maintained. 



METASTATIC TUMOR CELLS 



Metastatic, anaplastic carcinoma cells present nuclei which may closely 

 resemble malignant reticulum cells in imprinted preparations. This is an- 

 other reason why the use of imprints is supplemental to the study of the 

 histologic pattern in which the metastatic nature of the cell clusters is more 

 often clearly identifiable. The reader will have no difficulty in making 

 imprints of available tumors metastatic to regional nodes. Sheets of mo- 

 notonously patterned, anaplastic cells, unrelieved by the presence of any 

 members of the lymphocytic series, extreme degrees of pleomorphism in 

 clustered cell groups, and identifiable secretory or granular cytoplasmic 

 products attest to the epithelial nature of metastatic tumor cells in imprints. 



