207Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2
Named cells in dermatology
Fiona F. Sequeira, Suneil Gandhi1, Usha Kini2, Ishwar Bhat
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How to cite this article: Citation will be included before issue gets online***
Received: August, 2011. Accepted: November, 2011. Source of Support: Nil. Conflict of Interest: None declared.
INTRODUCTION
This article briefly describes the named cells in dermatology. It‘s purpose is to serve as a ready reckoner to the postgraduates during their quiz preparations. They include the following:A. General category1. Normal cutaneous anatomy: Langerhans cells,
Glomus cells, Veil cells, Mast cells2. Bullous disorders: Tzanck cells
3. Eczematous disorders: Tadpole cells4. Metabolic and storage disorders: Gargoyle cells,
Gaucher’s cell, Xanthoma cells5. Tumors: Basalioma cells, Basophilic and shadow
cells, Doughnut cells, Flower cells, Granular cells, Halo cells, Hibernoma cells, Paget cells, Sezary cells, Signet ring cells, Spider web cells, Strap cells, Reed Sternberg cells, Vulvar Clear Cells of Toker, Floret giant cells
6. Histiocytic disorders: Touton giant cells
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Departments of Dermatology and 2Pathology, St John’s Medical College and Hospital, Bangalore, Karnataka, 1Department of Dermatology, JN Medical College, Belgaum, India
Address for correspondence: Dr. Fiona F. Sequeira, Department of Dermatology, St John’s Medical College and Hospital, Koramangala, Bangalore, Karnataka - 560 034, India. E-mail: [email protected]
Table 1: Under general and infectious category
Name Description/location/size LM/EM Stains/markers Observed in/significanceLangerhanscell NamedafterPaulLangerhans.Isapale-
stainingnon-keratinocyte,withaconvolutednucleus.Itscytoplasmcontainsvimentinintermediatefilamentsandsmallrod-orracket-shapedstructurescalledLangerhanscellgranulesorBirbeckgranules[1]
LMEM
HandECD 1aS-100Langerin(CD207)
Aredistributedintheepidermis(preferenceforasuprabasalposition),oralcavity,esophagusandvagina.[1]Theyserveastheantigen-processingandpresentingcells.[1]
Theyarereducedintheepidermisofpatientswithdiseaseslikepsoriasis,sarcoidosisandcontactdermatitis,andincreasedinlangerhanscellhistiocytosis.
Glomuscell Theyarelargepolyhedralcellswitharound,centrally locatednucleusandapaleeosinophiliccytoplasm.[2] Thecellsareofsmoothmuscleorigin.Theycompriseofspecializedvascularstructurescalledglomusformations.[2] Theseformationshaveanarterialandvenoussegmentwithoutinterveningcapillaries
LMEM
HandEMyosinVimentin
Glomustumorsandglomangiomasarisefromthearterialsegmentofthecutaneousglomus,theSuquet-Hoyercanal.[2] Glomusformationsarespecialarteriovenousshuntsthatappeartoplayaroleinthermoregulation.[2]
Veilcell Theseareflatadventititalcellswithdistinctivenuclearstructureandprominentcytoplasmicprocessesthatsurroundthedermalmicrovessels.[3]Theylieexternaltothewall,demarcatingthevesselfromthesurroundingdermis.TheyexpressfactorXIIIaandVonWillebrandfactor[3]
LMPhase contrastEM
HandE It isstrategicallypositionedintheorganizationofthemicrovesseltoparticipateinthecontrolofbleedingatthemicrovascularlevel.[4]
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Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2208
Table 1: (Continued)
Name Description/location/size LM/EM Stains/markers Observed in/significanceMastcell Areroundtospindleinshapewitha
unilobedroundtoovalcentrallypositionednucleus.Itssizevariesupto5–13µm.Theycontainintheircytoplasmgranulesthatrangefrom0.3to0.8mm[5]
Mastcellssynthesizeanimpressiverepertoireofmediators,someofthemincludinghistamine,heparin,tryptase,chymase,carboxypeptidase,neutrophilchemotacticfactorandeosinophilicchemotacticfactorofanaphylaxis[5]
LMEM
HandE,Metachromaticstainingwithtoluidineblue,methyleneblue,alcianblueandGiemsa:Red-purple,Lederstain,MastcelltryptaseandChymaseCD117
Intheskin,mastcellsarepresentingreatestdensityinthepapillarydermis,neartheDEJ,insheathsofepidermalappendages,andaroundbloodvesselsandnervesofthesubpapillaryplexus.Theyarealsocommoninthesubcutaneousfat[1]
Activatedmastcellsaretheprimaryeffectorcells intheonsetofanallergicreaction.Theyplayaroleinthedefenseagainstparasites,stimulatechemotaxis,activation,andproliferationofeosinophils,promotephagocytosis,altervasotensionandvascularpermeabilityandstimulateconnectivetissuerepairandangiogenesis[1]
Theirnumbersareincreasedinmastocytosis.
Tastzellencells,Merkelcells
NamedaftertheGermananatomistFriedrichSigmundMerkel.Thesenon-keratinocytesareoval inshape,haveapale-stainingcytoplasmcontainingbundlesof intermediaryfilamentsandosmiophilicgranules.Thenucleusislargeandlobulated,andthemarginsofthesecellsprojectcytoplasmic“spines”towardthekeratinocytes[1]
LMEM
Silverimpregnation,CAM5.2orAE1/AE3,CK20,Neuron-specificenolase(NSE)
Theyarefoundbothinhairyskinandintheglabrousskinofthedigits,lips,regionsoftheoralcavityandtheouterrootsheathofthehairfollicle.Merkelcellsareslow-adapting,typeImechanoreceptors.MerkelcellcarcinomaisamalignanttumorofMerkelcells[6].
Tzanckcells/acantholyticcells/mourningedgedcells
It isnamedafterArnaultTzanck,aFrenchdermatologist.Thesearelarge,roundkeratinocyteswithanenlargedhyperchromaticnucleus,hazyorabsentnucleoliandabundantbasophiliccytoplasm.Thebasophilicstainingisdeeperperipherallyonthecellmembrane(“mourningedged”cells)duetothecytoplasm’stendencytogetcondensedattheperiphery, leadingtoaperinuclearhalo.[7] Incontrasttopemphigusvulgaris,theacantholyticcells inpemphigusfoliaceusandpemphiguserythematosusoftenhaveahyalinizedcytoplasmthatcorrespondstothedyskeratosisseenintissuesections
LM HandE,Giemsa,Papanicolaoustain,Wright,Methyleneblue,Toluidine blue
Pemphigus.Thisisaformofprimaryacantholysis.TheotherexamplesincludeDariers’sdisease,transientacantholyticdermatosesandwartydyskeratoma.Whenacantholysisoccurssecondarytosomealteration/damagetoepidermalcells,thetermsecondaryacantholysisisused.E.g.,bullousimpetigo,herpessimplex/zosterandsquamouscellcarcinoma.
Tadpolecells Arecellswitha“tadpole-like”shape.Presenceofmorethan10tadpolecells inaTzancksmearat×100magnificationisadiagnosticindicatorforspongioticvesiculardermatitis[8,9]
LM HandE Spongioticvesiculardermatitis.E.g.,allergiccontactdermatitis.
Gargoylecells/Hurlercells
Alargeovalorpolygonalcell,20µmindiameter,withapalecentralnucleus,thecytoplasmappearingclearonHandEstaining.Whenstainedwithtoluidineblue,metachromaticgranulesareseeninthecytoplasm.[10]OnEM,thecytoplasmoftheclearcells isseentobefilledwithlargeirregularclearvacuolesvaryinginsizefrom0.5μmto2μm.Themembranesofthevacuolesareoftenbrokenandtherupturedendscurl.Occasionally,mitochondriaandcisternsofendoplasmicreticulumareinterspersedbetweenthevacuoles
LMEM
HandE,Toluidineblue,Alcianblue
AreseeninHurlersyndrome.
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209Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2
Table 1: (Continued)
Name Description/location/size LM/EM Stains/markers Observed in/significanceGauchercells ThediseaseisnamedaftertheFrench
doctorPhilippeGaucher.Gauchercellsareglucocerebroside-ladenmacrophagesmeasuring50–60μmindiameter.Onelectronmicroscopy,theycontaintubularcytoplasmicinclusionsthatareconsideredtobetransformedsecondarylysosomes.Thefibrillarceramideaccumulationsareextensiveenoughtogivethecytoplasmadistinctive“crinkledbluetissuepaper”appearance[11,12]
LMEM
Wrightstain,PAS+,Ironstains
Gaucher’sdiseaseisaninheriteddisorderofceramidemetabolisminwhichanenzymedeficiencyleadstotheaccumulationofglucocerebrosideinmacrophagesofthebonemarrow,reticuloendothelialsystembutnottheskin.ThesecellsarenotdiagnosticofGaucherdisease.Cutaneousmanifestationofthisconditionincludepatchypigmentationoftheskinandpetechiae.
Xanthomacells Oftenwithinthesamelesionit’sappearancecanvaryfromeosinophilictocleartofoamyortomultinucleatedgiantcells,whichareoftenreferredtoasToutongiantcells[13]
LMEM
HandE,FatstainssuchasoilredOorSudanblackBarerequiredtovisualizelipiddropletsonfrozensections
Variousxanthomatoses,familialhyperlipoproteinemiatypesIIa,IIIandV,cerebrotendinousxanthomatosis,Wolman’sdisease,Tangierdisease,Hand–Schuller–Christiandiseaseandnormolipidemiccutaneousxanthomatosis.
Basaliomacells Trichoepitheliomascontainanepithelialcomponentcomposedofuniformsmallbasophiliccells lookinglikeepidermalbasalcellswithroundnucleiandcytoplasm.Theyarearrangedinstrandsandlobules.Theydisplayperipheralpalisadingandsometimescontainhorncystsorcalcifications[14,15]
LM HandE Trichoepitheliomas,BCC.
Basophilicandshadoworghostcells
Pilomatricomasaresharplydemarcatedtumorsthatpossesstwotypesofcells:Basophiliccellsandeosinophilicshadowcells.Theformerhaveroundorelongated,deeplybasophilichyperchromaticnucleiandscantycytoplasmsothatnuclei lieclosetoeachother.Thelatterareanucleate,eosinophilic,keratinizedcellshavingadistinctborderandpossessingacentralunstainedareaasashadowofthelostnucleus.Thesecellsfrequentlycalcify[16]
LM HandE Pilomatricomas.
Doughnutcells Theyaretheintranuclearcytoplasmicinclusionsinthelargeanaplasticmononuclearcells.[17]
Theseinclusionsaretheresultofdeepcytoplasmicinvaginationsintothenuclei.Nuclearindentation>70%ofthetotalnucleardiameteristhecriteriontotermitasahalf-doughnutcell[18]
LM HandEPapanicolaou,May-Grunwald,Giemsa,CD30+,Clusterin
Anaplasticlargecell lymphoma.
Flowercellsorcloverleafcells
Areperipheralbloodatypical lymphocytescharacterizedbyhavingirregularnuclearcontours,prominentnucleoli,condensedchromatinanddeeplybasophilic,occasionallyvacuolatedcytoplasm[19]
LM HandE,CD25+
AdultTcell lymphoma(ATL)isanaggressivematureT-cellmalignancycausedbyHTLV-I.Itaffectstheskinin43–72%ofthecases.Thediseasemanifestsitself intheskinaserythroderma,plaques,papules,nodulesandtumors.[20]These so-calledflowercellsareconsideredpathognomonicofATLandareseenintheperipheralbloodofthesepatients.[21]
Granularcells Arelargepolygonalcells inthedermiswithdistinctcellmembranesandprominenteosinophilicgranularcytoplasm.Thenucleiareusuallysmall,roundtoovalandcentrallylocated[22]
LM HandE,GranulesarePAS+diastase-resistant
Granularcelltumor,consideredtobeofperipheralnervesheathorigincaninvolvevariouspartsofthebody(skinandtonguebeingthemostcommonorgansinvolved).
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Table 1: (Continued)
Name Description/location/size LM/EM Stains/markers Observed in/significanceHalocells Intraepidermallymphocytesthatare
largerthanthenormallymphocyteswithconvoluted,cerebriformnucleiandaclearrimofcytoplasm[23]
LM HandE Areseeninmycosisfungoides.
Hibernoma-likecells,Mulberrycells,multivesicularcells
Are large(average-54microns) fatcellscontainingacentralnucleuswithamultivacuolatedscantygranular,eosinophiliccytoplasm.[24] The main histopathologicdifferentiationofadultadiposetissuefromhibernomacells isthepresenceofaclearcytoplasmandaneccentricnucleus[Figure1]
LM HandE Anuncommonneoplasmderivedfrombrownfat,[25] areseenmostlyinadults,withapredilectionforthethigh,back,axilla,neckandintrathoracicregion.
Pagetcells Areroundorovalcellsthatappearlargerthanthekeratinocytes.Theyhaveavacuolatedamphophilic,cytoplasmwithahypertrophicnucleus,scantynuclearchromatinandalargenucleolus.NodesmosomalattachmentsareseenbetweenPagetcellsandtheadjacentkeratinocytes[26]
LM HandE,PAS+
FoundinPaget’sdiseaseofthebreast.
Sezarycells,Lutznercells,Mycosiscell,Cerebriform lymphocytes,AtypiacellulesmonstreusesorMonstercell
FirstdescribedbyAlbertSézary.Areatypical lymphocyteswithagroovedorcerebriformnucleus.Thenuclearchromatiniscondensed inapatchydistributionbeneath thenuclearmembrane.Thenucleolimaybeprominent.Thecytoplasmissparseandappearsasanarrowrimaroundthenucleus.Mitochondria(oftenappearingclumped), roughendoplasmicreticulum,polysomesandcytoplasmicfibrilsareseen.Thecytoplasmicfibrilsappearserpentineonelectronmicroscopicexamination.Thesmallerversionsof thesecellsarecalledLutznercellsandthe largeronesasclassicalSezarycells[27,28]
LMEM
Wright,Giemsa,PAS
SeeninmycosisfungoidesandSezarysyndrome(bothintissueandinblood).
Signetringcells Thesecellshaveasinglelargevacuolefullofmucin.Thisvacuoledisplacesthehyperchromaticnucleustotheperiphery.[29]
Thepoolofmucininasignetringcellmimicstheappearanceofafingerhole,andthenucleusmimicstheappearanceofthefaceoftheringinprofile[Figure2]
LM HandE,Alcianblue,Mucicarmine
Areseeninmucin-producingadenocarcinomas.
Spiderwebcells Arepolygonalorovoidtumorcellsthatexhibitcytoplasmicvacuolesduetotheirglycogencontent.Residualstrandsofcytoplasmbetweenthevacuolesdefinespiderwebcells[30,31]
LM HandE Adultrhabdomyomas.
Strapcells Cellswithelongatedeosinophiliccytoplasm[32] LM HandE Aresuggestivebutnotdiagnosticofrhabdomyosarcoma.
ReedSternbergcells
TheyarenamedafterDorothyReedMendenhallandCarlSternberg.Arelargecellsthatareeithermultinucleatedorhaveabilobednucleus(resemblingan“owl’seye”appearance)withprominenteosinophilicinclusion-likenucleoli[33,34][Figure3]
LM HandE,CD30,CD15
Thepresenceofthesecells ispathognomonicforthediagnosisofclassicalHodgkin’slymphoma(HL).OtherthanHL,cellsresemblingReed-SternbergcellsmaybepresentinotherBandTcell lymphomas,carcinomas,melanomasandsarcomas.TheprevalenceofskininvolvementinHLisapproximately0.5–3.4%.
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211Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2
Table 1: (Continued)
Name Description/location/size LM/EM Stains/markers Observed in/significanceVulvarclearcellsofToker,intraepidermalglandularcells
ClearcellsofTokerareintraepithelialcellswithcleartopalestainingcytoplasmandblandcytologicfeatures.Theyarefoundintheepidermisofthenipple, immediatelyadjacenttotheopeningsofthelactiferousducts,alongthebasal layeroftheepidermisorscatteredinthestratumMalpighii.Tokercellsaredistributedassingleunitsorassmallaggregatesthatoccasionallyformsmall lumina.Theyhavebeenconsideredaprimitiveorgerminativecellofthelactiferousductorinterepithelialextensionofthelactiferousductcells[35,36]
LM HandE,CK7,EMA
Foundinapproximately10%ofnormalnipples.ClearcellsofTokerhavegeneratedinterestasapossibleprecursorcellofprimaryintraepidermalextramammaryPaget’sdisease,asmorphologicallytheyappeartobeabenigncounterpartofthemalignantcellsofPaget’sdisease.
Floretgiantcells Thesearemultinucleatedgiantcellsthathavemarginal,oftenoverlappingnucleiandaneosinophiliccenter[37]
LM HandE,Vimentin,CD34
Seeninpleomorphiclipoma,giantcellcollagenoma,giantcellfibroblastoma,giantcellangiofibroma,neurofibromatosistype1.
Toutongiantcells
Thesecellshaveaperipheralwreath-likearrangementofnuclei,withamphophiliccytoplasmcentrallyandpale,foamycytoplasmattheperipheryofthecelloutsidethenuclei[38]
LM HandE Seeninxanthoma,disseminatedxanthoma,juvenilexanthogranuloma,necrobioticxanthogranulomaanddermatofibroma
Hobnailcells Areplumpendothelialcellswithscantycytoplasmandenlargedprominent,hyperchromaticnucleiwithoneortwominutenucleoli.Theseendothelialcellsaredisposedinamonolayer,withnucleibulgingintothevascularlumina,resultinginacharacteristichobnailormatchstickappearance[39]
LM HandE Hobnailhemangiomaisararebenignvasculartumor.Itusuallyappearsasasingle,small,well-circumscribed,angiomatousorbrownish,flatorexophyticskinlesion.
LEcell TheLEcell istheendresultofeitherphagocytosisofdistortednuclearmaterialbyapolymorphonuclearleukocyteorautolysisofoneormorelobesofthenucleus[40,41]TheLEcellcontainswithinitscytoplasmtheLEbody,whichappearsasahomogenous,palebluetodeep-purplishmaterialpushingthenucleusofthephagocytetoonesideofthecell[Figure4].
LM Romanowskystains SLE.LEcellsarenotusuallyfoundinperipheralblood,althoughtheLEcellphenomenoncouldforminthebuffycoatofperipheralbloodafteraperiodof incubation.
Tartcells Atartcell isamonocytethathasengulfedanintact lymphocytenucleus.ItdiffersfromanLEcellbecausethesecondarynucleusretainsitsdefinitechromatinstructure[40,42]
LM Romanowskystains It isnotdiseasespecific.
Podophyllincells Bizarre,enlargedepithelialcellswitheitheraclumpedpyknoticnucleusorwiththenuclearchromatindisintegratedanddispersedassmallgranulesthroughoutthecytoplasmofthecell.These“podophyllincells”resemblecarcinomacells,butmaybedistinguishedfrommalignancybytheabsenceofcytologicatypiaandmultinucleategiantcells[43]
LM HandE Seenaftertheapplicationofpodophyllintonormalskin,verrucavulgarisandcondylomaaccuminata.
Mantlecells/corpsronds
Corpsrondsaredykeratotickeratinocyteswithasmallpyknoticnucleus,acidophiliccytoplasmandaperinuclearhalo(“mantlecells”)[7].Theyareseeninthestratumgranulosumanduppermalpighianlayer
LM HandE Darier disease.
Halfandhalfcells
Thesearetransformedkeratinocyteswhichshowincreasedsyntheticactivityinonehalfofthecell,andfibrillardegenerationintheotherhalfofthecell(resemblingthatofcolloidbodies).[44]
EM Phosphotungsticacid
Thesecellsareseeninlichenplanus,andarebelievedtoprovideausefulcluetotheearlychangesoccurringincolloidbodyformation.
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Table 1: (Continued)
Name Description/location/size LM/EM Stains/markers Observed in/significanceBeanbagcells Theyaremacrophagesthatbecome
engorgedbyphagocytosisoferythrocytes,lymphocytesandcellfragments[45]
LM HandE Seeninhistiocyticcytophagicpanniculitis.
Sunburncells Arepink,deadordyingkeratinocytescharacteristicofmammalianepidermisafterexposuretoUVCandUVBradiationorUVAradiationinthepresenceofpsoralens.Thesecellshaveapyknoticnucleusandashrunkenglassyeosinophiliccytoplasmandareseenscatteredthroughouttheepidermis[46]
LM HandE SeeninsunburnsandPUVA-inducedacutephototoxicity.
Ballooncells Thesearepolyhedralcellswithamplemicrovesicularcytoplasm,(ultrastructurallycorrespondingtoenlargedvacuolatedmelanosomes)sparsetoabsentpigment,distinctcytoplasmicmembranesandsmall,hyperchromatic,roundtoslightlyscallopedcentralnucleiandrareintranuclearvacuolesorpseudoinclusions[47,48]
LM HandE Ballooncellnevus.
Pekincells,Reitercells
Aremacrophages40µminsize.Theycontainoneormoreintactpolymorphonuclearleucocytesanddeepstainingbasophilicglobularstructureswithinthecytoplasm[49]
LM HandE InReiter’sdisease(50–70%ofsynovialfluidspecimens)aswellasanyotherinflammatorysynovialdisease.
Cluecells Aresquamousepithelialcellswithalargenumberofcoccobacillaryorganisms,Gardnerella vaginalisandotheranaerobicbacteriadenselyattachedinclusterstotheirsurfaces,givingthemagranularappearance.Thecytoplasmappearsfuzzy(likeshadingwithblackpencil)andtheedgesofthesquamousepithelialcells,whichnormallyhaveasharplydefinedcellborder,becomeindistinctorstippled[50][Figure5]
LM Papanicolaou,Gram Seeninbacterialvaginosis.Tobesignificantforbacterialvaginosis(BV),morethan20%oftheepithelialcellsonthewetmountshouldbecluecells.
Downeycells/Turkcells
NamedafterHalDowney.Areatypicallymphocytes,which,unlikeleukemiccells,showextremevariabilityofsizeandshape.Theyhaveabundantpalebluecytoplasm.Thenucleusmaybeirregularorindentedwithlightlystainingchromatin.Cytoplasmicedgesmaybeindentedbyotherbloodcells,leadingtoascallopedappearancecalledDutchskirting[51-53]
Oilimmersion
HandE,Giemsa
Seenintheperipheralbloodofinfectiousmononucleosispatients.Thedetectionofatleast10%atypicallymphocytesonaperipheralbloodsmearinapatientwithmononucleosishasasensitivityof75%andaspecificityof92%forthediagnosisofinfectiousmononucleosis.
GreenblattandPundcells
Arelargemononuclearcellsmeasuring25–90mmindiameter.Thenucleusofthecelliseccentricallyplaced,vesicularorpyknotic.Thereare<20intracytoplasmicvacuolescontainingDonovanbodiesineitheryoungnon-capsulatedormaturecapsulatedforms[54,55]
LM Giemsa,Leishman,Wright
Seen in granuloma inguinale.
Lepracells/Virchowcells
NamedafterRudolphVirchow.Lepracellswhenstudiedbymeansofvitalstainingarefoundtobederivedfromthehistiocyteoftheinfectedtissue.Theirprotoplasm,whichformsthegreaterpartofthecell,isfilledwithvacuoles,andcontainsenormousnumbersofleprabacilli.Thenucleusisusuallysingleandis,asarule,pressedtoonesidebythevacuolesandbacillithatcrowdthecellbody.Insomeinstances,thesevacuolesaresonumerousthatthereislittleactualprotoplasmremaining,thecellbodyhavingtheappearanceofafoam.[56]Intimeandwithantimycobacterialtherapy,degeneratebacilliaccumulateinthemacrophages,theso-calledlepracells,whichthenhaveafoamyorvacuolatedcytoplasm[Figure6]
LM ModifiedFiteFaracostain
TheyareobservedinlepromatousleprosyTheyresemblexanthomacellsand,onstainingwithfatstains,areshowntocontainlipid, largelyneutralfat,andphospholipidsratherthancholesterol [57]
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213Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2
Table 1: (Continued)
Name Description/location/size LM/EM Stains/markers Observed in/significanceMickuliczcells Alargehistiocytemeasuring10–100mm
indiameter.Ithasapale,vacuolatedcytoplasm.Withinthecytoplasmofthesecells,onefindsmanyKlebsiellabacilli[58]
LM Giemsa,Gram,Warthin-starrysilver,PAS+
Thecharacteristiccell inrhinoscleroma.
VonHansemanncells
NamedafterDavidPaulVonHansemann.Arelargemacrophageswithabundantfoamyeosinophiliccytoplasmandaprominenteccentric,hyperchromaticroundnucleus.Variablenumbersof intracytoplasmic,concentrically laminated,round–ovoid,basophilic inclusionsareappreciatedandarereferredtoasMichaelis–Gutmannbodies[59]
LM HandE,PAS-positive,Diastaseresistant
Seen in malakoplakia.
Langhansgiantcells
NamedafterTheodorLanghans,aGermanpathologist.Theyareformedbythefusionofepithelioidcellsandcontainmultiplenucleiarrangedinahorseshoe-shapedpatterninthecellperipheryorarearrangedcircumferentially[60]
LM HandE Seenintuberculoidgranulomas.E.g.,tuberculoidleprosy,cutaneoustuberculosis,gummaofsyphilisandsporotrichosis.
Wrightcells Arelargemacrophagesthatcontainnumerousprotozoagroupedtogetherinatypical“swarmofbees”fashionwithintheweaklybasophiliccytoplasm[61]
LM MayGrunwald,Giemsa
Seenincutaneousandmucosalleishmaniasis.
WarthinFinkeldeycells
Atypeofgiantcellthatvaryinsize,butcancontainasmanyas100nucleipercellalongwithcytoplasmicandnuclearinclusions[62]
LM HandE Pathognomicformeaslesinfection.Foundinreticuloendothelialsystem,exanthem,Koplikspotsandrespiratorysecretions.
Koilocytes Arehumanpapillomavirus-infectedvacuolatedkeratinocytesthatbearabasophilicpyknoticnucleussurroundedbyaclearhaloandpale-stainingcytoplasm.Theyarelocatedintheupperstratummalpighiiandinthegranularlayer.Theycontainfewornokeratohyalinegranules[63]
LM HandE Verrucavulgaris.
Mitosoidcells Arekeratinocyteswithirregularlyshapedhyperchromaticnucleithatsimulatemitoses.Theyareinfactdegeneratednucleiwithoutmitoticability[64]
LM HandE Infocalepithelialhyperplasia(Heckdisease).
LM:Lightmicroscopy,EM:Electronmicroscopy
Figure 1: Hibernoma. Large polyhedral fat cells containing eosinophilic granular cytoplasm (×200)
Figure 2: Signet ring cells in an adenocarcinoma. Sheet of large cells with vacuolated cytoplasm pushing the single hyperchromatic nucleus to the periphery (×400)
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