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Sea-Blue Histiocytes

Michael A. Baumann, MD; Joseph A. Libnoch, MD
JAMA. 1983;250(11):1459. doi:10.1001/jama.1983.03340110067041.
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Sea-blue histiocytes were found scattered throughout Wright-Giemsa-stained smears of a bone marrow aspiration from a 33-year-old man with recently diagnosed chronic myelogenous leukemia. Such cells have been occasionally discovered in bone marrow since the original report by Wewalka1 in 1950. A genetic syndrome has become recognized having a usual presentation early in the third decade of life with hepatosplenomegaly and thrombocytopenic purpura. Macular abnormalities, unexplained pulmonary infiltrates, and neurological abnormalities have been seen in some patients. Pathologically, infiltration by histiocytes is seen in bone marrow and spleen. The histiocytes are typically 20 to 60 μm in diameter and have a single eccentric nucleus with a prominent nucleolus. Contained in the cytoplasm are numerous large granules that stain brilliantly blue-green or sea-green on Wright-Giemsa-stained preparations. These granules are also stained intensely by Sudan black and other lipid stains, and increased storage of sphingomyelin and glycosphingolipids has been found in the


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