Tubular complexes of endoplasmic reticulum in lymphoblastic lymphoma: case report

Distinctive intracytoplasmic tubular complexes have been identified occasionally by electron microscopy in a wide variety of hematologic and nonhematologic disorders. The mechanism of induction and significance of these tubular complexes are unknown. Tubular complexes were identified in the majority of bone marrow lymphoma-leukemia cells in a patient with documented lymphoblastic lymphoma in lymph node. These complexes varied in size but in general ranged from 800--1500 nm, and consisted of masses of nonparallel, twisted, smooth, 40-nm tubules. Continuity with adjacent endoplasmic reticulum was evident in some of the complexes. Cytochemical characteristics of the malignant cells included strong, focal, paranuclear acid phosphatase reactivity and strong, stippled nuclear terminal deoxynucleotidyl transferase positivity. Flow cytometric analysis showed a DNA-RNA content pattern consistent with acute lymphoblastic leukemia and typical of T-cell lymphoma. This represents the first report of such tubular complexes in a presumed T-cell malignancy.