Sternberg-Reed Cells in the Peripheral Blood of ... - Blood Journal

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Sternberg-Reed of Patients

Cells with By

With

I

T IS spleen,

well known liver and

it spreads and

the

throughout

The first

possibility

of

in

blood

who

were

In

within

1902: of

by

and

disease.

a vessel support

into

the

However,

In

examinations this

in the

smears

noses

of

we

2 patients

present

the

of leukocyte

Hodgkin’s

leukocyte mized

in only

report,

postmortem

of

patients

concentrates

disease.

concentrates

in

who

had

We the

also

report

and

of a

giant

in some

cells

sections dissemina-

only 890 the

routine

generalized for

disease.

with

cells

confirmed

comparative splenic

in

peripheral

Sternberg-Reed

patients

and

cells

8 isolated cases patients studied

diag-

observations

artery

of

of 3 splenecto-

disease. AND

METHODS

of Study

Among

the

circulating

numeroims

blood,

we

the

silicone

flotation

the

specific

gravity

Dow-Corning gravity 1.075.

the

This

investigation and

First BERTHA

University,

miiethods chose

of the

submitted

of

various

Seal.”

the

2, 1965;

A. BOURONCLE, M.D.: Columbus, Ohio.

the

demonstration

quantitative,

method

method

blended blood

Ohio

supported from

for not This

710 are heparinized

of Medicine, was

June

but

takes

of

cancer

which

advantage

cells

in

the

is a modification of

the

of

differences

in

cells.

555 an(l of fresh

Department CA-06196-02

described

a simple.

technique

Silicone Five ml.

From OJA1

in cell

Sternberg-Reed

in

search

our

vein

MATERIALS

Method

our

in 135

splenic

Hodgkin’s

found

advanced of

great

organs these

of hematogenous

presence

with

in occur

parenchyma.

were

results

occur

addition,

possibility

cells

was morbid

Sternberg-Reed

Sternberg-Reed

institution,

the

occasionally

locations the

the

cells

and

in biopsied

disease of

reported

in perivascular

through

disease.

giant

gland

in

In

nodes, there

dissemination,

Hodgkin’s

“These

Marchal2

Hodgkin’s

frequent

of

description

blood smears is a rare occurrence and in the world’s literature.31#{176} Among

blood

lymph From

lymphatic

routine peripheral have been reported our

in system.

classic

the

and vessels

from

observations

Hodgkin’s

in

her

sinuses

blood

died

as being

early

of

invasion,

in

Jeanselme

to be passing

These tion

lymph

1926,

had

described

appeared

Mann

originate

dissemination

Reed’

disease

large

observed

patient

disease can reticuloendothelial

local

hematogenous

Dorothy

Hodgkin’s the

vessels.”

emboli

the

by

of

numbers

by

of Rosemary

dissemination.

suggested

pathology

body

the

Blood

BOURONCLE

assistance

Hodgkin’s organs of

the

by hematogenous

A.

BaavriiA

technical

that other

in the Peripheral Hodgkin’s Disease

by National accepted Associate

State Public

is

achieve carefully

University, Health

Cancer for

to

5 ml. of layered

Columbus, Service

solution above

of a specific the silicone

Ohio.

Research

Grants

CA-06196-

Institute.

publication Professor,

Aug.

2, 1965.

Department

of

Medicine,

27,

No.

Ohio

State

544 BLOOD,

VOL.

4

(APRIL),

1966


STERNBERG-R.EED

solution

and

being coat of

the

lighter care

10 slides on

graphed

by

easily achieving

“seeded”

in

were

first

cells

were

normal

tumor

in

Pasteur and

The

silicone

pipette. are

by

and

involved

we

the

This

with

mixed

an

Stemberg-Reed

and

form

Smears

stained

with

expert then

the

effectiveness

cells,

a distinct

are

prepared,

Wright’s

stain.

technician.

are

buffy giving

Scanning

Suspicious

personally

abdominal

saniple

cells

examined

and

described

concluded

that

to

with

the

our

technic

the

are

photo-

normal

our

in

the

nodes,

obtained

individtmals

the

results

isolating

The

“seeded”

at

and

Sternberg-Reed

From

is effective

lymiiph

scraped

and

technic.

to

the

(1)

mouse

numbers normal

of

blood.

technic:

following

technic.

amount

above

infected

fresh

from

silicone

proportionally

mixed

from

blood

the

of an

proportionate

disease

compatible

the

processed

in

Hodgkin’s

of

cavity

was

smears

with

following

node

determine

from in stained

smears

lymph

to

blood.

and

stained

experiments.

fine

out

minutes.

of the

edges

is carried

obtained

processed

the

Hodgkin’s

15

for

surface

mnicrolocator

present

scra1)ed

were

found

a

employed

were

grossi

were

samples

a

visible

sample

human

cells

( 2 ) Areas

stmrgerv.

with

with

rpm

author.

tumor

ascites

blood

1500

to lie on the

readily

slide

the

at

conic

aspirated

each

tests

Ascites

cells.

is

the

Several

centrifuged

1.075,

to for

marked

tube

than

which

special

545

CELLS

then

cells

were

material of

of

the

the

above

Sternberg-Reed

2

or similar

cells.

Material Employing

the

peripheral disease.

of

During

individimal

was was

controls.

patients

4-year

period

during

the

1060.

from

8

Another

silicone

135

this

patients

performed range

described

blood

technic who

91

years.

control

of

of

1 to

illness. 50

of

number

and

57

with

of

were

individuals

patients

past

4

determinations

total

males

the diagnoses

49

The

healthy

22

for

pathologic

were

group

consisted

examined,

from

their

patients A

group

have

confirmed

of observation, course

Seventy-eight to

we

had

the

Hodgkin’s

were

done

on

determinations

females.

were

proved

years,

of

The

used

as

diagnoses

age

normal

of

lvmpho-

sarcoma.

In each

of 3 patients

hypersplenism,

3

obtained

from

the

sample

from

15 ml.

of blood

made

the

from

Hodgkin’s

disease

were

obtained

artery,

the

vein

after

at

who the

second

manual

underwent timime

sample

squeezing

of

splenectomy surgery.

from

the

splenic

the

spleen

by

of

for

The

first

the

and

in

the

other

2 it was

idiopathic

and

was

the

surgeon.

obtained per sample and was divided into 3 tubes. tube and reviewed for the presence of Sternberg-Reed carried out in three splenectomized control patients; in 1

spherocytosis,

secondary sample

vein,

was

was

hereditary

splenic

splenic

each

experiment

with

samples

third

A total

Ten

slides

cells.

of were

A similar

the diagnosis

thrombocytopenia

was

purpura.

RESULTS

Peripheral The slides

Blood results from

of

tions with In other smears. low

our

with

advanced

cells We

stages peripheral

Hodgkin’s addition

have

demonstrated

Hodgkin’s

of them are in monocytes

in routine

1. Atypical number

study

patients

present. Many Such increase or in the

Studies that

disease

a marked

large and young is more pronounced of their

disease.

white

in

cell

cells

seen

increase

concentrate in monocytes

forms, and some have during the periods This

blood

leukocyte

finding

is

vacuoles. of activity

confirms

our

observa-

counts

from

patients

differential

disease. to the

usual

were

found,

have

arbitrarily

normal which

are

classified

celLs which are rarely in leukocyte concentrates

rarely these

on or

cells

the never

routine found

differential in

routine

but

are

slides, blood

in 3 groups:

found in routine of normal subjects.

slides

found

in


546

I3ERTIJA

2. Abnormal concentrates

cells which are of normal subjects.

Neoplastic

3.

patients

cells

with

Among

the

strongly

near or

delicate.

normal

subjects

slides

which

are

type

or

leukocyte

only

found

in

which

are

hut

structure

in

because have

of the

greater

cells in

their

in

be

most

the

patients

blue, area

either

likely

slides with

dark

perinuclear

can

They

these

numbers

of

a clear

nucleus

distinguished.

found

have

out

frequently

usually

We

stand

They

coarse represent

prepared

from

Hodgkin’s

disease

1).

h.

Cells

slides

in

of

our

patients mitosis,

niitosis

in

the

by

normal

contrary,

leukocytes in

were

( Fig.

4 ). The

been

reported Hi.stiocytes,

in

they

also

Hodgkin’s

patients

in patients described the

disease,

as many

edge,

appearance tiles, cellular is oval,

so that

the

cell

kidney

appearance and f. Endothelial

shaped

in

of 2). huffy from

in patients cytoplasm,

or round.

intact

of

nuclear

On

immersion

field has

cells, of

discern,

has

were the

found normal

disease. gray-blue

They with

giving

of various or platelets.

strimcture

color (Fig. 5). in small clusters

sur-

rare.

concentrates

some

to

fre-

megakaryo-

with Hodgkin’s which is pale

is difficult

The

oil

or reticnlimm

contained vacuoles red cells, white cells

found

were

numerous

concentrates

stains to a light purple celLi, often arranged

field of cytoplasm centrates of normal

found

stages ( Fig.

sometimes

in leukocyte

membrane

of a veil. The cytoplasm debris, phagocytosed

were

subjects,

as 2 or 3 per

with carcinoma.’ as macrophages leukocyte

shapes

megakaryocytes

of megakaryocytes

in

concentrate

frequently

in the normal in the huffy coat

and

normal

intact

being found more frequently as large cells with abundant

a delicate

sizes of

However,

with

numbers

leukocyte

more

occasionally found

3). of different

incidence

recently

the

were

These mitotic cells were at different to the atypical mononuclear cells

concentrates

in some

high

small

subjects, appeared

sizes, The

the grannucle-

a honey-comb by

a large

of grayish-blue color, were seldom found in leukocyte subjects; however, they were seen in patients with

surrounded

conHodg-

disease.

We

found

that

which

are

normal

subjects.

a.

observed but

( Fig.

platelets.

patients

found,

cytes

kin’s

disease. to belong

Hodgkin’s disease of nlegakaryocytes

rounded

very

rarely

subjects,

hinucleated cells were also found were numerous and very frequently

(lilently

C .

control

Hodgkin’s they seem

Patients with d. Nuclei

the

very

‘ere

normal

with and Small they

c.

coat;

us

routine

found:

chromatin

Nucleoli monocytes.

(Fig.

we

cells

The

altered

in

cells cytoplasm.

nucleus.

in either

Sternberg-Reed

mononuclear

basophilic

the

the

found

BOURONCLE

disease.

atypical

Atypical

a.

of

Hodgkin’s

not

A.

Large

monocyte nucleoli

not

patients

with

present

in

They

include:

atypical

either

mononuclear

having large nuclei, and hasophilic cytoplasm

Hodgkin’s

disease

routine cells with (Fig.

slides are irregular 6).

present or

other

leukocyte

2 to 4 times structure

abnormal

cells

concentrates

larger and

than one

of

a normal or

several


srEnNBEI(;-1EED

547

CELLS

----I.--

----

-._----

-.

C .

.

w’

,.‘

2

!

ti.

S.

.. ‘ii

*.‘

Plate disease.

1.-Leukocyte

probably

ami atypical

Fig.

mnegakam’ocvte. : Large

Large

1:

Atypical

miiomionuclear

Fig. atypical

atypical

concentrates of peripheral miiononuclear cell. Fig.

.5:

mononuclear binucleated

cell.

cell

cell.

Fig.

Fig.

Histiocvte.

Reduced

.3: 6:

with

Small

Large minineroims

20

P’

cent

blood 2:

of patients in

Cell binucleated

atypical

cell.

mnagmiificatiom

Hodgkin’s

(mnetaphase)

Fig.

rnommonimclear

cvtoplasmnic from

with

mitosis

4:

Intact

Fig.

cell.

‘acimoles. 2400

Fig.

x

8:


548

BERTHA

1). Large c. Large same

atypical atypical

nicnonuclear binucleated

cytoplasmic

and

celLs cells,

nuclear

with

numerous

some

of

characteristics

A.

( Fig.

vacitoles

which

of the

are

cells

BOURONCLE

7).

elongated

with

described

the

( Fig.

above

8). These

three

ulu.m

transitional The the

next

large

stages

of reticulum

group

consisted

The

chromatin

irregular

microns

in shape,

Fifty

per

typical

and

of

per

the

abnormal

atypical

cells obtained

patients

had

alive

who and

We

also

frequently

Hodgkin’s

Of

were

were

the

found

mainly

found

only

s’died, cells

of them the

nuclear

very

cells

85 (63 per cent) or Sternherg-Reed

group,

25

during time

patients

the

of their

(18.5

presence

of

illness.

the

atypical

time

hinucleate of clinical

in patients

in

large,

of activity and

large

remission.

showing

generalized

and

cells were in whom

peripheral blood still responded to of 1#{189}to 3 years duration. Three their

leukocyte

concentrates

are

still

to therapy.

observed

that

associated

the

presence

with

the

of Stemberg-Reed

involvement

of

cells

abdominal

has

l)cen

organs

by

Studies

Of interest are samples obtained disease. surgery,

the results of our observations at the time of splenectomy

Patient 1 was and patients were

in earlier

in an advanced stage 2 and 3 developed

stages

of their

in leukocyte on 3 patients

concentrates from with Hodgkin’s

of Hodgkin’s disease secondary hemolytic

at the anemia

cells

were

artery, and only sample, obtained Reed cells were

found

in

the

time of while

disease.

Patient 1 illustrates the results of our splenic studies. We found careful scanning of 10 slides prepared from each of 3 samples, no Reed

multinu-

disease. In 18 patients, these to death. However, 4 patients

were found in the further remissions

are

or are

showed

course

the

in

differ-

9-16).

latter

during

during

Hodgkin’s 1 day prior

nucleoli

studied

large

found

Stemberg-Reed

this

Some

are

disease.

Splenic

they

the

only

found

lobulations;

disease abnormal

patients

occasionally

were

their to

responding

have

more

of

sometime

but

cells

retic-

of

They

binucleate

The

( Figs.

stained

was

cells. mono,

staining.

positive.

and disease.

showing

and

deeply

were

cells

Sternberg-Reed therapy and

sometimes

described

advanced stages of found from 4 months

altered

characteristics

cells

are

with Hodgkin’s concentrates for

cells

mononuclear

Stemberg-Reed

Sternberg-Reed They

number

disease,

the

Hodgkin’s

of typical large,

cent)

cells

Hodgkin’s

with

diameter.

usually

total

pathologically

recognize neoplastic

patients

thickness

Sternberg-Reed

The of

is

135 patients leukocyte

(37

)

cent

in

nucleus

Among the negative

cells.

of definitely of

of variable

is

resemble

can

cells.

variations 50

cells

we

concentrates

as

cleated.

abnormal

morphologically

morphologic

as

of

and

leukocyte

ent

had

groups

cells,

first

blood

sample

obtained

from

that after Sternbergthe

splenic

1 large atypical binucleate cell was seen. In the second from the splenic vein, 12 abnormal cells and 5 Stembergfound. In the third sample, obtained from the splenic vein


STERNBERC-REED

549

CELLS

#{149}1 15

Plate disease.

2.-Leukocyte

cleated

with

nucleated, Fig.

cells:

prominent lobulated

14:

concentrates

Sternberg-Reed

nucleoli. with

Trinucleated.

16: Multinucleated per cent from magnification Fig.

of peripheral Fig.

9: Fig.

ctoplasmic Fig.

15:

with

2400

11:

Binucleated

x.

and

Binucleated

vacuoles.

prominent

blood

Bimiucleated Fig. with nucleoli

1.3:

of patients with

nucleoli.

Two

cells

lobulated and

with

with

Hodgkin’s 10: Binu-

Fig.

elomigated.

Fig. in

nuclei vacuoles.

the

12:

same

and

Bifield.

vacuoles.

Reduced

20


550

BERThA

after

manual

squeezing

Stemberg-Reed from peripheral 1 large

of

cells blood,

binucleated

atypical

spleen

cell.

The

cell

day

surgeon,

21

abnormal

cells

and

12

( Figs.

17-24). Leukocyte concentrates surgery, revealed the presence of only

after

with

the

BOURONCLE

surgery

vacuoles

2 binucleated

were

found;

cells

no

and

1 large

Stemberg-Reed

cells

seen.

Pathologic disease.

examination

The

revealed

spleen

of the

weight

generalized

Special

of the

for

the

spleen

contained

large

berg-Reed

cells.

was

presence

of

that

many

revealed

atypical

reticulum

Similar

studies

done

on patient

cells

in either

the

obtained

and

after

present

in the

were

found after

As

sample

squeezing

control

mized

patients,

No

the splenic s(ueezing

from

characteristics

studies

of the

the

the

splenic splenic

the of

spleen

capillary the

spleen

represent

abnormal splenic

Patient

in

vessels

possibly

neither or the

the

splenic

cells

vein

Sternnor

Stern-

samples.

In the

spleen,

22

abnormal

cells

3 showed

no

abnormal

cells

artery, vein

samples

and

10 abnormal

samples

were

thrombocytopenic

abnormal

cells

artery or splenic of the spleen. The

logic

cells

may

of

of the

25).

sinusoidal

which

Hodgkins

by

cells

obtained

directly

spleen.

similar

2 of idiopathic

spherocytosis.

the

artery

between

of the

studies,

of

present.

obtained divided

( Fig.

Sternberg-Reed

squeezing

were

infiltration examination

disease

2 revealed

splenic

cells

equally

gross

Microscopic

cells

mechanical

4 Stemberg-Reed

revealed

Gm.

by Hodgkin’s

berg-Reed samples

spleen 919

infiltration

search

vessels

and

by

were detected obtained before

mononuclear

were

the

A.

or

Stemberg-Reed

vein samples only occasional

of histiocytes.

splenectomized

obtained

and

cells

cells

with

were

also

Hodgkin’s

3

splenecto-

1 of hereditary

were

found

obtained before large cells found

Similar

patients

in

purpura

and had

found

disease

in

either

after manual the morphoin the

( Fig.

5).

of

patients

splenic

Disussiox The

presence

Hodgkin’s

of

disease

total

of 890

found

only

patients on

isolated

cases

The

presence

cent.

the

scattered

in our

cells rare.

been

or

These

0.2

our institution of the bone agree

lesions

with

which

past

In

the

per

cent.

cells

in routine

other may

specific lesions their aspiration

cally

of Hodgkin’s

finding

the

with

observations

15 years,

such

world’s

of cells

literature,

needle

bone

marrow

Sternberg-Reed cells have marrow in 43 of 890 patients

and also because the fibrous tissue, making constant

smears

periodic

a

were only

8

reported.’

findings focal

routine

numerous over

of Sternberg-Reed In

in

In

institution,

2 occasions, have

tions is also rare. routine examinations per

Stemberg-Reed is extremely

reports.2’2’

not

be

in the more invasion

This

aspirated

by

hone marrow difficult. This of bone

aspira-

been found in studied, or 4.8

is probably

due

the

needle

sternal

tend to have explains the in fatal

marrow

to

much practiautopsy

cases.--

The Hodgkin’s

periodic disease,

examination conducted

of the over

leukocyte the

concentrates past

4 years

in

in

our

135

patients

with

laboratory,

has


STERNBERC-REED

551

CELLS

1” r

I,

Plate 3.-Leukocyte concentrate of splenic vein kin’s disease. Sternberg-Reed cells: Fig. 1 7: Two with

indented

vacuoles.

Fig.

20:

vacuoles.

Fig.

21:

22:

cell

Mononuclear Fig.

membrane X;

cvtoplasmic

Mononuclear

Multinucleated.

cvtoplasmic from 2000

and

nucleous

magnification

cell 23:

and

-

23

for

Figs

cells

vacuoles.

with with

Fig.

reduced

from

patients

same

field.

19:

large

nucleoims

Magnification 18-24

in

Fig.

prominent large

Multilobulated.

vacuoles.

samples

and 24:

Cell nucleoli

with

Binucleated

per

17 cent

Cell

cvtoplasmic miucleoli. with

redtmced from

Hodg18:

cvtoplasmic

and

promninemit

for Fig. 20

with Fig.

20

2400

Fig.

irregular per

x.

cent


552

BERTHA

Fig.

25.-Patient

Hodgkin’s

revealed

the

group,

Magnification

presence

( 18.5

25

cells

1. Microphotograph

disease.

The

also

during

in small

cells

resemble

cent) the

numbers

we

previous

have

studies

from

the

The

we

This

have

activity

of

during

periods

in patients 25 patients, However,

the

presence as indicating

ing

an immediately

we

by

or 37 of

typical

A

few

per

cent.

Of

this

Sternberg-Reed reports

of

similar

published.8”3”4

previously from have

as

abnormal

reticuloendothelial

that

described

cells cells.

Sternberg-Reed

nodes

Three continuing

an advanced outcome.

found

some

occasions

The

cells were found still responded

fatal

illness.

were

on

advanced

of Stemberg-Reed

ered

and

cells but

remission.

of from 1#{189} to 3 years duration. since they are still alive and

of infiltration

cells transitional

of patients

In

derive forms

with

Hodgkin’s

accepted.mm4

disease,

generalized

these

view

of lymph

transitional

of clinical

7 patients

the

system,

Hodgkin’s with

forms

supported

is generally

or

been

described

observations

view

abnormal

and

presence

their

transitional

microscopy

disease.’5

of have

classified

areas

in 50 patients, the

course

reticuloendothelial

in electron

cells

revealed

of patients

morphologically

showing

BOURONCLE

X.

of abnormal

per

sometime

results

of spleen

318

A.

cells stage

mainly

Sternberg-Reed

stages

the

time

were

also

present

cells

of Hodgkin’s

from 4 months to therapy and

during

they

were

disease.

to 1 day prior obtained further

found In

of only

17 of the to death. remissions

of the 7 obtained even longer remissions to respond to therapy. Consequently, in the of the

peripheral disease

blood but

not

must necessarily

be

considpredict-


STERNBERG-REED

In

spite

553

CELLS

of the

the incidence been as high

fact

that

of abnormal as 40 cells

the

individual

patient

and

patient.

It is then

cells

Both

the found

were

trast

to

exfoliated metastases In some l)eared

from

despite

emphasize did

the

Nineteen

of the differ

group.

It is possible Sternberg-Reed stimulated the

thelial

and

seems

the

to

for

macrophages

true

due to their found to be

tained

per

disap-

some

in-

important

cent)

gave

to

negative

disease,

and

from

the

they

similar

immediately

active cells of

the

These

cells

peripheral

blood

is

circulation.

They

are

cells

which

transiently

to the

of large cellular is one which explanation

demonstrated

in experimental

studies

gain

entry

of the this

done

that

their

further

supported

and

abnormal Hodgkin’s

of surgery

obtained

from

the

splenic

obtained

from

the

splenic

showed

studies

no

cells

Samples

of

Sternberg-Reed

However, and

our

in greater

they

were

number

very

large

the

first

filtering

blood.

elements was

which suggested

low

size filtered

peripheral

histiocyte The

on

to be monocytes,

blood and are stages of Hodgthe

in the

incidence three

circulating cells present in the

The may by count

phenomenon

in rabbits.

transitional

disease.

artery. vein,

by or

the

is

presumably

same

un-

into

cells

escape

in the

in

is presently the reticuloendo-

Sternberg-Reed

in

those

system, reticuloendothelial

this process cells from

the

Only

Hodgkin’s disease and monocytes are

reticuloendothelial

of

has

with time

in

size, are able to circulate in the peripheral increased during the active or advanced is

patients

occurred

the

form

cells

findings

organs

number

be found

by Kiyono

cells

at the

lungs.

Simpson25

kin’s disease. This hypothesis tomized

to

obtained

of the

action by the lungs the general circulation

smaller markedly

Stemberg-Reed

(63

con-

of

defenses

It is also

determinations

other

the in

would

applied

blood.24

viability

far-advanced

simultaneously.

reason

of the

and

had

cells

and

remaining

capillaries

in arterial

has

or laboratory

which initiates of these various

absent

concept of a filtering gain entrance into Aschoff23

this

that in patients with cells, other abnormal

increase

their

capillaries of the

However,

even

liver

The

against

effect

them,

agent production

frequently

militates

Sternberg-Reed

from

spleen,

circulation.

small

of

production

nodes,

system

general

the

patients

to hypothesize cells, transitional

The stimulating However, the

known.

to therapy,

of a remission.

cells in

negative.

in their

lymph

system.

by

some

were

The

patient’s

of clinical

high. smears,

clusters.

85

per and

Sternberg-Reed

concentrate

patients,

sample cells

be quite

typical

in

cells has per each

5 ml.

the

135

negative

in terms

In

to death

of

the

leukocyte

evidence

group

per

overcome

blood.

qualitative,

was

Sternberg-Reed

at times,

found

to

study

cells

total

and

the

responded

in our

must,

usually

objective

the

cells

are

peripheral

any

clearly

positive prior

who

as 30

that

in

in our

cells and Sternberg-Reed on periodic observations

many

blood

and the ability not studied.

that

not

peripheral

which

patients

stances

as

isolated

cells

cells were

1 to apparent

or transitional

individually

cancer

findings.

from

in the

abnormal

employed

transitional total number

per

individual transitional

technic

or

blood in the in the

samples

of

splenecob-

samples samples obtained


554

BER’rIIA

the

from

splenic

distribution

Reed

cells

they might

explain

the

In

the

ologic

of

patients

view

of

effect

atypical should

leukocyte

of

cells, higher who

technic

or a definite

have

easier

not

The

these

with

spleen

Hodgkin’s

study

confirmed

periph-

are

able

of the

the

cells

disease

of in

is essentially

as a screening

to

path-

presence

veins. for Sternberg-Reed

considered

after This

in the

cells

microscopic

Hodgkin’s

the

or

with

more

patients

of Sternberg-

circulation.

involvement

the splenic the search

he

prognostic

the

cells

number

filtration. from

the

the

to

BOURONCLE

Because

that

reached

abdominal

patients

spleen.

access

circulating

inside that

the

is possible

of Sternberg-Reed

had

spleen

should

it

they

find

higher

of

and

after

capillary

the

of

spleen,

incidence

their

concentrates

disease

the

spleen,

reticulum cells be emphasized

search

squeezing

of

the

of the

sections

large It

manual

transitional in

blood

escape

after

circulation

produced

also

disease.

the

and

are

eral

vein

of

A.

test

the a re-

for

Hodgkin’s

those

suffering

test. SUMMATIY

Our

observations

from

of

Hodgkin’s

the

peripheral

cells

were

The fatal

the

18.5

per

cent

of

of the

l)ut

per

cent

of

leukocyte

of their

illness.

Typical

patients

and

were

concentrates

of

Sternberg-Reed

present

only

in

the

disease.

cells

disease

37

in the

Hodgkin’s

of Sternberg-Ileed

stage

that

cells

course

of generalized

presence

indicate

abnormal

during in

stages

advanced

exhibit

blood found

advanced

patients

135

disease

in the

does

not

peripheral

necessarily

blood predict

indicates

an

an immediately

outcome.

Comparative lation, patients ent

studies,

showed with

in the

Hodgkin’s

splenic

for

hypothesis

Sternberg-Reed

cells

Sternberg-Reed

cells

disease;

vein,

A possible ripheral

searching

no Sternberg-Reed but

after

is given an

support

the

Nostre

observationes de

anormal

de Steriiberg-Reed presente solmente Le

for

IN

cells

squeezing

evidence their

for

lower

circu-

arteries were

of the the

of pres-

spleen.

circulation

incidence

in

of the

pe-

de

cellulas

avantiate

del

de morbo

metastasis

indica

37

que

durante Ic dcl sanguine 18,5 de

non

in

predice

pro

curso

disease.

centa

del

clinic

per

peripheric.

pro cento generalisate

Sternberg-Reed sed

of Hodgkin’s

INTERLINCUA

patientes

characterisate leucocytic

esseva trovate in in le stadios avantiate

presentia

stadio

135

in

Hodgkin es in le concentratos

morbo

Typic

del patientes morbo de

Ic sanguine

de

cellulas cellulas

e esseva Hodgkin.

peripheric

necessarimente

casos

un

indica imminente

mortal.

Studios

comparative,

splenic,

revelava

Hodgkin,

sed

splenic,

the

hematogenous

SUMMARIO

exito

mechanical

splenic

splenic

Sternberg-Reed

to support

explanation

in the

in the

blood. observations

Our

tin

cells

present

numerous

particularly and

to he

cercante

nulle numerose

particularmente

tales cellulas post

cellulas

in Ic arterias de

de

Sternberg-Reed

splenic

Sternberg-Reed

compression

mechanic

de

in

patientes

esseva del

splen.

presente

Ic

con

circulation

morbo

de

in le vena


STERNBERC-REED

formulate

Es

cellulas

555

CELLS

un

de

hvpothese

in

Sternberg-Reed

supporto

e un

del

explication

evidentia

pro

pm

br

plus

del

metastase

Ic

basse

circulation

de

incidentia

in Ic

peripheric.

sangtmine

Nostre

supporta

observationes

morbo

de

le conception

hematogene

de

Hodgkin. ACKNOWLEDGMENTS

We

are grateful

review

of this

to Doctors

Charles

A. Doami

and

Jacob

\V. Old

ammd

for their suggestions

manuscript. REFERENCES

1.

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D.

\I.:

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2.

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1966 27: 544-556

Sternberg-Reed Cells in the Peripheral Blood of Patients with Hodgkin's Disease BERTHA A. BOURONCLE and Rosemary Mann

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