2^4 The Lymphocyte and Lymphocytic Tissue 



disease changed from a paragranuloma to a granuloma (Fig. 17-13F). The 

 fibrosis may be construed as evidence of progression toward a granuloma. 

 The increased number of plasma cells between the islands of lymphatic tis- 

 sue (Fig. 17-135) have been found in both paragranulomas and granulomas 

 of long duration. In comparison to the original node, the node obtained in 

 l ( .). r ) ( J had a more irregular architecture, not as dense a lymphocytic infiltrate, 

 and more scarring and plasma cells. This patient has since had a good re- 



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13CS 



13D 



Fig. 17-13 (Contd.). (C) Bone marrow, 1953, hyper- 

 plastic myeloid tissue, (x 80) (D) Bone marrow, 

 1959. serous I at atrophy, artifact due to mixture of 

 blood and marrow (A), (x 80) 



spouse to x-ray therapy directed to an abdominal mass which caused gastro- 

 intestinal symptoms, chills, fever, and weight loss. In the last 6 years, the 

 duration of each treatment-induced remission has slowly decreased; this 

 observation seems to be correlated with the change in the histopathology of 

 the lymph nodes and marrow which will be described in more detail (see 

 below). 



The cytologic features of a paragranuloma indicate, as in chronic lym- 

 phatic leukemia and giant follicular lymphoma, that a good therapeutic re- 

 sponse is to be expected and that the prognosis may be just as good if no 

 treatment is given. The one common denominator in all three diseases has 



