Blood, 1961, Vol. 18, No. 1, pp. 73-88.
© 1961 American Society of Hematology, Inc.
Phospholipid Accumulation in Histiocytes of Splenic Pulp
Associated with Thrombocytopenic Purpura
SIDNEY L. SALTZSTEIN 1
1 Division of Surgical Pathology, Washington University Medical School, and
Barnes Hospital and The Barnard Free Skin and Cancer Hospital, St. Louis, Missouri.
Accumulation of a lipid, histochemically a phospholipid, in the histiocytes of
the splenic pulp was observed in seven patients with thrombocytopenic purpura. Six had classical idiopathic thrombocytopenic purpura with abundant
megakaryocytes in the bone marrow. Splenectomy resulted in clinical and
hematologic remissions in four of these six, continued thrombocytopenia in the
fifth, and in the continued requirement of corticosteroid to maintain a reasonably normal platelet count in the sixth. The seventh patient, who died shortly
after splenectomy, had marked hypoplasia of megakaryocytes. Similar lipid
accumulation was not seen in more than 700 other spleens, removed for a
variety of reasons, reviewed in this study. Platelet phagocytosis has been suggested as a source of the lipid.
Submitted on January 11, 1961
Accepted on April 27, 1961
