Changes in polymorphonuclear leukocytes as a manifestation of malignant neoplasia.

Abstract

Malignancy associated changes in polymorphonuclear leukocytes were studied in routine Wright-Giemsa and Feulgen stained smears of blood from 254 patients (131) patients w/o tumors, 70 w/carcinoma and 53 w/multiple myeloma, lymphosarcoma and various leukemias. The cells were examined at the highest magnification of the light microscope by use of a x100 oil immersion objective and x16 wide field oculars and by closed circuit television microscopy at x16,000. In patients without tumor a prominent chromocenter and straight chromatin bands in each of the leukocyte lobules were usually present. In patients with malignant tumors the nuclear structure in the leukocytes consisted either of the orderly MAC with numerous pale circular areas surrounded by conspicuously evident chromatin bands or of the disorderly arranged malignancy associated structure with deeply stained-chromocenters and chromatin bands of varying size. In addition a variety of ancillary changes were noted. These were decreased or abnormal segmentation, nuclear excrescences such as hair-like appendages, short and long rods and clubs and the target formation. These changes, though more frequently found in patients with malignant tumors, were not considered significant for the interpretation of MAC. The presence of MAC in blood leukocytes was noted in 81.4% of patients with carcinoma, in 70.0% of those with various leukemias, in 62.5% of those with multiple myeloma and in 70.6% of those with lymphosarcoma. In patients without evidence of tumor MAC were found in 14.5% of the cases. The presence of MAC in the high percentage of patients with malignant tumors is suggestive of a systemic involvement of the host. The reasons for the occurrence of MAC in cases without evidence of tumor remains undetermined until further information is available from continued observation of these patients.