The coexistence of ribosome-lamella complex and annulate lamellae in chronic lymphocytic leukemia

An electron microscopic study of peripheral blood and lymph node from a patient with chronic lymphocytic leukemia revealed ribosome-lamella complexes in 11-16% of the peripheral lymphocytes and in 14% of the nodal lymphocytes. Annulate lamellae were seen in 2-8% of the peripheral lymphocytes and in 8% of the nodal lymphocytes. One peripheral blood specimen revealed coexistence annulate lamellae and ribosome-lamella complexes within the same cells in an additional 4% of the lymphocytes. The two structures were connected by continuous strands of apparent endoplasmic reticulum. Although annulate lamellae and ribosome-lamella complex have each been described in chronic lymphocytic leukemia, albeit uncommonly, their unusual association with one another has not previously been documented and might offer a clue as to the origin and role of these interesting structure. The possible ramifications of these observations include relationship of the structures to endoplasmic reticulum and protein synthesis, to in vitro and possible clinical induction by drugs including "antitubulins," and to induction in vitro by viral infection.