Mechanism of eosinophilia. VII. Eosinophilia in rats with lymphoma

The role of eosinophil in regulation of granulopoiesis

An association between eosinophilia and neutropenia has been observed in a number of clinical conditions. To probe the role of eosinophils in granulopoiesis, marrow and peritoneal eosinophils, obtained from Schistosoma mansoni-infected mice, were separated and purified. Normal bone marrow cells were cultured in semi-solid culture medium in concentrations ranging from 5 X 10(4) to 5 X 10(5), with and without added eosinophils. To examine whether high prostaglandin E (PGE) content of eosinophils affects granulopoiesis, indomethacin was added to duplicate marrow cultures containing eosinophils. The addition of eosinophils to normal syngeneic marrow culture caused a significant inhibition of granulocyte-macrophage colony formation (CFU-GM) in culture. This suppressive effect was reversible upon addition of indomethacin. These findings suggest that eosinophils, in vitro, are capable of inhibition of granulopoiesis. The reversal of this effect by indomethacin indicates that this suppression may be prostaglandin mediated.

The pathogenesis of eosinophilic endomyocardial disease in patients with carcinomas of the lung

Studies were done on a patient with a carcinoma of the lung induced by hypereosinophilia who was thought to be at risk from developing eosinophilic endomyocardial disease to see whether the development of heart disease could be related to abnormalities in the morphology or kinetics of blood eosinophils. The patient was a 61-year-old man who had a partial resection of a squamous cell bronchial carcinoma of anaplastic large cell type which has spread locally. Seven months later, he developed a blood eosinophil count of 33.9 x 10(9)/1. There were only transient responses to treatment with steroids and tumor irradiation, and he died 15 weeks later. Up to 3 x 10(9)/1 blood eosinophils were degranulated, correlating with serum levels of eosinophil cationic protein. The blood half-life of 111indium-labeled eosinophils was prolonged to 53 h, but their distribution was normal. Although an unsuccessful search was made during life for the development of endomyocardial damage, at postmortem the left ventricle had features of eosinophilic endomyocardial disease in the acute necrotic stage. Among 13 other reported patients with carcinoma of the lung and hypereosinophilia, three also had endomyocardial disease or myocardial lesions. These findings confirm the suggestion that the presence in the blood of greater than 1 x 10(9)/1 degranulated eosinophils can be used to predict the development of eosinophilic endomyocardial disease before it becomes apparent clinically, and they also add weight to the hypothesis that blood eosinophil degranulation causes this complication of hypereosinophilic states.

A case of gastric carcinoma with massive eosinophilia

This report describes a 67-year-old male with inoperable gastric cancer accompanied by marked tissue and peripheral eosinophilia without evidence of allergic disorders or parasitic infestation. Autopsy revealed an advanced gastric cancer of scirrhous type with metastases to pancreas, bone marrow, ileum, lungs, and lymph nodes. Excessive numbers of mature eosinophils were present in univolved bone marrow, liver and spleen as well as among the signet ring cell component of the cancer in either primary or metastatic sites. The primary cancer also possessed a component of tubular adenocarcinoma which was associated with only a few eosinophils. Hence, we speculate that an eosinophil mobilizing (chemotactic and/or proliferating) factor (s) was produced by the signet ring cancer cells.

Malignant lymphoma associated with marked eosinophilia

A 60-year-old black man with poorly differentiated lymphocytic lymphoma presented with generalized lymphadenopathy and marked eosinophilia. Extensive evaluation of the eosinophils revealed them to be normal morphologically and functionally. The patient responded to corticosteroid therapy with resolution of the lymphadenopathy and reversion of the peripheral blood counts to normal limits. Recurrence of the original clinical picture within months prompted institution of systemic chemotherapy. Response was transient, and the patient expired after an unremitting downhill course. Recent advances in our knowledge of mechanisms of eosinophilia and eosinophil function are reviewed. The relationship of lymphoma to eosinophilia is discussed.

Unique eosinophil granules in a case of T-cell lymphoma

A 41-year-old man developed intense itching without visible cutaneous changes, epigastric pressure pain, and a slight intolerance to alcohol. He was found to have persistent blood eosinophilia. The eosinophil granulocytes were of abnormal appearance in the light microscope: larger than normal, the nuclei were multilobulated (4-6 lobes), the cytoplasm contained atypical, large granules, ample glycogen, and up to 12 vacuoles. In the electron microscope too the eosinophil granules were entirely atypical, having an electron-dense matrix, often with a light central inclusion body which was inhomogeneous, having longitudinally oriented structures with a periodicity of about 10 nm. These findings are quite contrary to normal eosinophil granules. Enzymic studies of cytoplasmic enzymes from the granulocytes revealed a greatly reduced content of eosinophil cationic proteins, whereas 5 (7) other enzymes were present in a normal or slightly reduced quantity. The phagocytic capacity of the eosinophils against latex particles was normal. The patient developed generalized lymphomas, histologically very malignant, of the convoluted, acid phosphatase positive cell type (T-cell lymphoma). Sub-population studies of lymphocytes from a lymph node revealed 58% TE cells, while the remainder were B cells. At death, 3-1/2 years after the onset of symptoms, severe endomyocardial fibrosis was found. The thymus could not be identified. It is concluded that lymphomas should be described on the bais of clinical, histological, and histochemical criteria as well as studies of lymphocyte sub-populations and that the highly unusual eosinophil granulocytes still deserve particular attention. The endocardial fibrosis is assumed to have been due to substances liberated from the eosinophil cells.