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Morphology
and
Cytochemistry
Body
of Leukemic
By
A
RARE
within
acute
and
hitherto
the
cytoplasm
leukemia.
designated
to study
For
G.
of
the
with
vacuole-like
certain
descriptive
period
from
revealed
the
seven
three
cases
were
found
moist
and
slide
addition,
Wright’s
it
fixed
served
as
an
indication
The periodic
saliva-labile
demonstrated
stained
by
with
the
modifications
of the
and Sekiya.m#{176}
The M. nadi
chrome
oxidase
hipoid
test
three
to
an
. 2
year
have
included
Auer
bodies
blood
or
Janus
bone
green)
field microscopes.3
of
and
1mm
the
and
possibly
(0.2%)
Nile
phosphatase
Peroxidase
activity
utilized
for
bltme
Sudan
pentosenucleo-
were
Acetal
lipids
was
snmggest.ed
indicated
possible
Lipids
B.’ Neutral
black
sulfate.7
w.a.s
nucleal
toluidine
mucopolysac-
activity
the
of
lipids.’
unsaturated
of
a
pentosenum-
the
sohmtion
demonstrate
solution
of
of
or
to
alkaline
of
means
to
nmndigested
and
presence
by
mucopolysaccharides
employed
subjected
(ligested
detect
w-as
solution
was
of
and
red
minutes
aqumeous
alcoholic
and
procedumres.9
of Sato
or
for
to
70%
aqueous
Gomori
eight
These
a drop
bright
demonst.rated
esters
a
to
and
made
exposure
Acid
reaction.8
an
leukemia;
of ribonumclease
was
sulfate
a saturated
plasmal
it
(.ells.m
University,
recognized.
tneutral
commtrast
was
to
over
State
monocytic
coverslip
vapor
stain
exposure
were
of
A coml)arison
of
he
examined.
acid Schiff
reaction
glycogen,
cerei)rosides
following
was
phase
formalin
following
reviewe(l
Ohio
simpravitally
routinely
Wright’s
leumkemia
a cleami
the
were
with
of leukeniic
Hospital,
cases
or
1)esoxypentosenucleoprotein
protein.6
charides,
with
shall
cases.
touching
procedures:
with
found
patiemits
structure
bodies
i)odies
four
unstained
with
films
Metachromasia
shown
these
an
examined
been
seven
METHODS
University
and
by
upon
stained
stained
films
reaction.’
fat
prepared
were
cleoprotein.4
of
Auer
chronic
granumle-vacimole
four
dried
films were
of cytochemical
control
blue
in
films
and
leukemia
inverting
prepared
Air
number
which
in
has
from
cytoplasmic
and
AND
acute
Service,
granubocytic
associated
Fresh
marrow
of
Hematology
cases
of
this
granulation
ca.ses
cells
body.
It was the purpose
of this investigation
cytochemist.ry
of this structure
and (ompare
MATERIALS
500
structure
leukemic
purposes
cytoplasmic
Approximately
the Granule-Vacuole
Cells
ACKERMAN
undescrihed
as the granule-vacuole
the morphology
and
briefly
ADOLPH
of
by
the
demonstration
were
by
method
of cyto-
material.’
OBSERVATIONS
Granule-vacuole
stained
moist
yellow
globules
Between
bodies
and
one
exhibit
supravital
(0.5-4.0
and
six
their
films.
u)
and
most
They
comit.ain
granule-vacuole
characteristic
appear
one
or
bodies
appearance
as round,
more
may
small
be
in
moderately
granules
present
in
tin-
refractile
(figs.
the
1-3).
cytoplasm
of the leukemic
cell. Most
commonly
these
bodies
are found
in monoblasts
and
young
monocytes
of acute
monocyt.ic
leukemia
and in late B and C niyelocytes
and
mature
neutrophils
in granulocytic
leukemia.
Although
the frequency
of
these
bodies
in acute
leukemia
is markedly
less thami the frequency
of Auer
bodies,
these
From
h)US,
the
t.wo
aberrant-
Department
of
structures
Anatomy,
have
Ohio
often
State
been
University
associated
College
Ohio.
Submitted
Augumst.
13,
1956;
accepted
for
publication
443
Oct.
22,
1956.
in
of Medicine,
t.he
cells
Colum-
of
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444
GRANULE-VACUOLE
1 -Frequency
TABLE
Bone
of Granule-
Marrow
of
Seven
of
cent
OF
Bodies
with
CELLS
Auer
Bodies
Granulocytic
bodies
leukemic
LEUKEMIC
and
Acute
granule-vacuole
.
Leukemia
Vacuole
Patients
Per
,
Type
BODY
and
in
Found
in the Blood
Monocytic
Leukemia
Per
cent
cells
Bone
Blood
Auer
bodies
leukemic
Marrow
and
in
cells
Blood
Bone
Marrow
Granulocytic
1
0.0
2
*
20.0
8
3
0.0
1.0
0.0
19.2
0.0
8.0
0.0
Monocytic
1
0.0
68.0
0.0
2
0.0
6.4
0.0
0.0
3
1.8
8
0.2
8
4
1.6
8
0.4
8
Percentages
8
No films
the
are
samue
rarely
The
calculated
available
patient.
(table
seeii together
leukemic
truded
upon
bodies
cells
from
containing
the
undergo
vacuole
bodies
are
vacuolar
with
revealed
a
vacuoles
are
neutral
fat.
pent
are
is
respects
miot.
philic,
oxidase
found
the
t.hat
in the
with
Nile
acet.al
lipids,
vacuoles.
The
has
blue
as a slight
The
pink
PAS-positive
a strong
membrane
osmic
sulfate.
Pentosemiucleoprot.ein,
amid
material
oxidase
and
vapor
exhibits
a
strong
and
alkaline
phosphatase
de(fig.
5);
desoxy-
alkaline
amid
appears
om- cortex
acid
of t.his
to
bodies
vacuole
with
aoid
smaller
stain
granule-vacuole
portion.
portion
The
and
fixation
glyo-ogen,
acid
the
the
pres-
alcohol-labile,
6).
vacuoles
of
a light
alcohol
less
(fig.
of a strongly
amid exhibits
granular
plasmnal-positive
as well
larger
of a
a deep
instances
of t.he
being
a sudamiophilic
prior
which
stained
Iii most
action
reaction
granular
fluid matrix
consisting
a mucopolysaccharide,
show-n
staimi.
imiclusiomi,
the
bodies
vacuole
enlarges.
of the granule-vacuole
the
port.iomi
of
of the
be
ex-
without.
granules
muay
as the
soluhility
the
dye.
vacuolar
morphology
vacuoles
basophilic
than
are
plasma
with
the
elaboration
gramiules
are staiiied
by
granular
bodies
the
cytoplasmic
to Wright’s
and
from
PAS-posit.ive,
activity
ccrt.aimi
changes
aberrant
is dissolved
these
into
or in the
Smaller
exposure
inclusion
Romamiowsky
of the
osemmucleoprot.cimi,
not.
red.
reaction.
The
vacuole
with Sudan
black
after
monstrahle
from
alcohol-labile
less
to consist
of a rather
(fig. 4), most. probably
peroxidase
cell
property
disappears
the stainability
amid
azurophilic
also
in some
arise
while
solution
stromig
deep red w-ith the
The
cytochemist.ry
differs
in
of the
dye
exhibits
neutrophil
of the
neutral
this
following
portion
emit in the
activity
bodies
color,
but
variations
cells.
Frequemit.ly,
mature
aiid
cytocheniical
this granule.
These
(acidic)
orange-red
Marked
leukemic
structures.
of the
in the
morphologic
surrounding
orange-red
these
cytoplasm
apparent
alteration
(fig. 2).
The
gramiule-vacuole
of 500
1). However,
gramiule-vacuole
bodies
and Auer
bodies
in the same
leukemic
cell.
bodies
are not. the result
of in vitro
alteration
since
immediate
examination
of unstained
moist
films (fig. 3).
do not seem
to impair
motility
or mitotic
activity
in
granule-vacuole
they
are present
Gramiule-vacuole
the
from
a count
examination.
for
0.2
.
phosphatase
imiclusion
is sudano-
oxidase
reaction.
and
per-
From www.bloodjournal.org by guest on June 17, 2017. For personal use only.
‘I’
1-A
Fm;.
myelocvte
Sumpravital.
X
Fic;.
2 -An
siomm imit
Fm;.
No
C)
the
4.-A
cyt.oplasmw
Fm;.
appear
no
Supravit
i)e
late
stains
5.-A
‘‘C’’
observed
myelocyte
a lighter
mayelocyte
with
foumr
within
‘‘B’’
color
‘‘B’’
the
edge
youmng
remains
of
two
monocyte
in eachi
of
the
the
inclumsions.
umst ext
j
-
five
several
staimis
-
vacuole
the
imiclusiomis.
Wright’s
staimi.
445
X 27(X).
black
A small
granule
i michum-
-vacuole
vacuolar
Prel)arat
-
imicluisiomis.
X
Two
B.
immclumsiomm.
iomi
vacuole
acid-Schiiff.
Snmdami
several
inclumsiomis.
A (barker
staimiimig
large
moist
staimiimig
Periodic
immcltmsiomis
a grammu le
omie
aimie(l
deeply
with
gramiumle-vacuole
ruded
and
Umist
immclusions.
comitainimmg
exhibiting
inclimsioni
sized
sized
vacuoles
comitaimiing
which
has
moderate
(lie
thani
muoderate
1 which
X 27(X).
to
6.-A
still
two
al.
have an oumter capstmle
coumiterstain.
X 2700.
Fmc;.
material
at
-
mnyelocyte
could
contaimming
mnot i le mietit rophii
l)ltt51i1
3.-A
gramiules
FIG.
‘‘C’’
2700.
actively
of
Suidami
X
27(X).
Time
27(X).
t lie
black
amoumit
of the
mmiv also
be
imi(-ltmsiolms
B with
vacumolar
observed
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446
GRANULE-VACUOLE
2.-Summary
TABLE
of the Chemical
red
acidic
OF
Composition
Inclusions
LEUKEMIC
CELLS
of Several
Cytoplasmic
Granu!e-Vacuo!e
Young
Cytop!asmic
Granu!es
Reaction
Neutral
BODY
Auer
acidic
Kurioff
to
more
more
neutral
neutral
and/or
Body
Body
Granu!e
to
Organelles
Body
Vacuole
acidic
unstained
network
ppt.
l)y
dye-
acidic,
re-
mainder
unstained
Birefringence
-
network
-
ppt.
by
dye-
positive
Azurophilia
+++
+++
-++++
-++++
Metachroma.sia
+
Mucopolysaccharide
+
++-+++
Glycogen
--++
Neutral
-
-
++-+++
+++
+++
+
+
Pentosenucleoprotein
+
+ +
Desoxypentosenucleo-
-
Acetal
++++
-
fat
Phospholipid
+
++
++
phospholipid
++
+
++
-
protein
Cvtochrome
(?)
oxidase
+++
-++++
Peroxidase
Acid
++++
++++
phosphatase
Alkaline
phosphatase
Genieral
++++
---+
--+
solubility
++++
-
--+
-
soluble
pro-
tein
soluble
and
pro-
tein
+++
--+
soluble
and
highly
relatively
pro-
solu-
in-
soluble
phospho-
phospho-
tein
ble
lipid
lipid
and
phos-
phos-
pho-
pho-
lipid
lipid
membrane
Table
2 represents
vacuole
bodies
stances
with
cells
and
that
with
phocytes
a summary
and
the
of normal
of the
attempts
of
the
to
the
cytoplasmic
composition
intensities
granules
intracytoplasmic
guinea
cytochemical
compare
and
globular
of the
of
Auer
Kurloff
the
bodies
bodies
granule-
reactive
seen
sub-
of
leukemic
in
the
lym-
pigs.2
DISCUSSION
The
cytochemical
reactions
vacuole
inclusions,
cytoplasmic
cytochemically
amount
action.
from
in
The
lipid
the
inclusions
membrane
than
of the
a close
granules
cytoplasmic
of each
constituent
The
PAS,
oxidase
color
indicat.e
and
granules
as determined
and
peroxidase
in
either
vacuole
the
inclusion
correlation
Auer
and
between
bodies.
Auer
by the
reactions
The
bodies
the
inclusions
principally
granulediffer
in
the
relative
intensity
of the reproduce
a more
intense
cytoplasmic
is extremely
granules
or
alcohol-labile
Auer
bodies.
in con-
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G.
trast
with
the
chemical
partial
ADOLPH
soluhility
similarity
of
of
Auer
447
ACKERMAN
the
bodies,
granules
and
cytoplasmic
Auer
bodies.
granules
The
and
the
cyto-
granule-
vacuole
bodies
suggests
that
the granule-vacuole
inclusions
arise
as the result.
of degeneration
or malformation
of certain
cytoplasmic
granules
due t.o an alteration
in the metabolism
of certain
leukemic
cells.
It is also possible
that
the
vacuole
surrounding
the granule
may
result
from
a cytoplasmic
reaction
to
the presence
of these
aberrant
granules.
SUMMARY
A
rare
and
hitherto
undescribed
body,
found
in the cytoplasm
leukemia
has been
described
sion has been compared
with
ring
in leukemic
vacuole-like
of certain
morphologically
the cytoplasmic
Es
presentate
ancora
un
que
locytic
descriptioii
describite
vacuolari,
IN
granule-vacuole
esseva
trovate
Iste
de Auer
e cytochimic
vacuoloide,
de
in cellulas
rar
como
certe
es comparate
occurre
de
desigmiate
in le cytoplasma
inclusiones
que
INTERLINGUA
morphologic
structuras
e mnonocytic.
le corpores
the
of granulocyt.ic
and nionocytic
and cytochemically.
This
inclugranules
amid Auer
bodies
occur-
cells.
SUMMARIO
non
structure,
cells
numic
granulo-
in leucemia
cellulas
con
e usque
corpores
le granulos
gramiu-
cytoplasniic
e
leucemic.
REFERENCl’S
1
2
G. A.:
ACKERMAN,
cells.
Blood
tion,
The
:
AND
Ohio
histochemical
C.:
the
A study
of
l)haSe
contrast
cytoplasmic
the
cells
Auer 1)odies
omi the
of
the
hemopoietic
cells
of
in
system.
leukemic
l)isserta-
1954.
dyscrasias.
The
studies
(he
Blood
living
microscope.
10:
basophilia
1183-1203,
of
the
II.
1)100(1
Blood
and
and
bone
bone
marrow-
in
marrow-
from
1955.
bone
marrow-
cells,
J.
Path.
&
Bact.
59:
1947.
A. G. E.:
‘PEARSE,
Histochemistry,
Theoretical
and
Applied.
Boston,
Little,
Brown
J. J.,
Blood
AND
3: 641-655,
E. V.:
COWDRY,
Wilkins
Co.,
WmsLocKI,
G.
B.:
Histochemical
methods
applied
to
hiemiiatology.
1948.
LaI)OratOry
Technique
in Biology
and
Medicimie.
Baltimore,
Williams
&
1952.
E. H., A
rigorous
re-definition
of the
plasmal
reaction.
Stain
Technol.
24:
19-23,
1949.
9
R.4BmNovmTcH,
phosphatase
10
WINTROBE,
&
1953.
RHEINGOLD,
HAYES,
of
Umiiversity,
with
hematobogic
J.
223-234,
8
and
N. C.:
films
various
WHITE,
Co.,
State
BELLIOS,
supravital
6
Microscopic
5: 847-863,
1950.
Cytochemistry
amid morphology
M.,
AND
ANI)REUCCI,
distribnmtion
M. M.: Climiical
ui normal
Hematology,
I).:
A histochemical
human
l)omie
Philadelphia,
study
marrow.
Lea
of
“acid”
amid “alkaline”
Blood
4: 580-594,
& Febiger,
1951.
1949.
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1957 12: 443-447
Morphology and Cytochemistry of the Granule-Vacuole Body of Leukemic
Cells
G. ADOLPH ACKERMAN
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