Summary
Muscle biopsies from two cases of polymyositis were examined with the electron microscope, particular attention being given to the inflammatory cells in the lesions. Lymphocytes which were enlarged and possibly “activated” were found in contact with the endothelium of small venules; they were also seen apparently traversing the vessel wall. Venular endothelial cells were often swollen with reduplication of the basement membrane. Perivascular and interstitial cells comprised small lymphocytes, larger transforming lymphocytes with distinctive morphological features, pleomorphic macrophages and a few plasma cells and granulocytes. In one case cells resembling primitive lymphoid cells were found internal to the basement membrane of several muscle fibres. Peripheral blood lymphocytes from both patients were stimulated on incubation with a crude muscle homogenate. The lymphocytes also appeared to be cytotoxic to cultures of foetal human striated muscle. The significance of these findings is considered in relationship to the pathogenesis of the muscle fibre damage in polymyositis.
Zusammenfassung
Muskelbiopsien von 2 Polymyositisfällen wurden elektronenmikroskopisch untersucht, wobei den Entzündungszellen in den Läsionen besondere Aufmerksamkeit geschenkt wurde. Vergrößerte, möglicherweise „aktivierte Lymphocyten” fanden sich in Kontakt mit dem Endothel kleiner Venolen; man traf sie auch beim Durchtritt durch die Gefäßwand an. Die Endothelzellen der Venolen waren oft vergrößert, die Basalmembran verdoppelt. Die perivasculären und interstitiellen Zellen rekrutierten sich aus kleinen Lymphocyten, größeren Lymphocyten mit den deutlichen morphologischen Zeichen der übergangsformen, pleomorphen Makrophagen sowie einigen Plasmazellen und Granulocyten. Bei einem Fall wurden innerhalb der Basalmembran mehrerer Muskelfasern Zellen gefunden, die primitiven lymphoiden Zellen ähnelten. In der Inkubation mit einem Muskelhomogenat wurden Lymphocyten vom peripheren Blut beider Patienten stimuliert. Die Lymphocyten erwiesen sich auch gegen Kulturen von fetalem quergestreiften menschlichen Muskel als cytotoxisch. Die Bedeutung dieser Befunde wird in Hinblick auf die Pathogenese der Muskelfaserschädigung bei Polymyositis erwogen.
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Mastaglia, F.L., Currie, S. Immunological and ultrastructural observations on the role of lymphoid cells in the pathogenesis of polymyositis. Acta Neuropathol 18, 1–16 (1971). https://doi.org/10.1007/BF00684472
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DOI: https://doi.org/10.1007/BF00684472