Thiele J, Krech R, Choritz H, Georgii A
Virchows Arch B Cell Pathol Incl Mol Pathol. 1984;46(3):253-63. doi: 10.1007/BF02890314.
A combined morphometric and ultrastructural study was performed on so called emperipolesis or internal wandering of myeloid cells in the cytoplasm of large mature megakaryocytes. Measurements were made on material from a total of 115 patients comprising a normal control group and 5 groups with subtypes of chronic myeloproliferative diseases, including primary (essential, idiopathic) thrombocythemia (PTH). A significant increase in this peculiar phenomenon was noted in myeloproliferative disorders and especially in PTH where the frequency of emperipolesis showed a positive correlation with the number of anuclear cytoplasmic fragments sectioned, with the circular deviation of the shapes of megakaryocytes and with the extent to which the peripheral thrombocyte count was elevated. Electron microscopy in selected cases displayed the integrity of the plasma membranes of engulfed hematopoietic cells within the dilated cavities of the megakaryocytic demarcation membrane system (DMS) and no evidence of phagocytosis. Moreover there was a close relationship between engulfed myeloid cells and the presumptive sites of platelet shedding which had their openings from the cisternal lumina of the DMS. Our results demonstrate that emperipolesis of hematopoietic cells within megakaryocytes should not be regarded as a special nosological feature, but as an indication of enforced thrombocytogenetic activity which is expressed particularly in PTH.
对所谓的血细胞入胞作用，即大的成熟巨核细胞胞质内髓细胞的内部游走，进行了形态计量学和超微结构的联合研究。对总共115例患者的材料进行了测量，这些患者包括一个正常对照组和5组慢性骨髓增殖性疾病亚型患者，其中包括原发性（特发性）血小板增多症（PTH）。在骨髓增殖性疾病中，尤其是在PTH中，这种特殊现象显著增加，在PTH中，血细胞入胞作用的频率与切片中无核胞质碎片的数量、巨核细胞形状的圆形偏差以及外周血小板计数升高的程度呈正相关。在选定病例中进行的电子显微镜检查显示，巨核细胞分界膜系统（DMS）扩张腔内被吞噬造血细胞的质膜完整，且无吞噬作用的证据。此外，被吞噬的髓细胞与血小板脱落的假定部位之间存在密切关系，血小板脱落部位从DMS的池腔开口。我们的结果表明，巨核细胞内造血细胞的血细胞入胞作用不应被视为一种特殊的疾病特征，而应被视为血小板生成活动增强的一种表现，这在PTH中尤为明显。
