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Whipple's disease is a rare systemic infectious disease caused by the bacterium Tropheryma whipplei.First described by George Hoyt Whipple in 1907 and commonly considered as a gastrointestinal disorder, Whipple's disease primarily causes malabsorption, but may affect any part of the human body, including the heart, brain, joints, skin, lungs and the eyes. [1]
The foam cells of monocyte/macrophage origin are positive for KP1, HAM56, CD11b and CD68 as pointed out by Nakashiro et al. in xanthogranulomatous cholecystitis). [20] Many T lymphocytes were identified by these authors positive to CD4 and CD8. Macrophages and T lymphocytes demonstrated a marked expression of HLA-DR antigen.
Foamy macrophages are also found in diseases caused by pathogens that persist in the body, such as Chlamydia, Toxoplasma, or Mycobacterium tuberculosis. In tuberculosis (TB), bacterial lipids disable macrophages from pumping out excess LDL, causing them to turn into foam cells around the TB granulomas in the lung. The cholesterol forms a rich ...
Also known as xanthelasmatic giant cells, Touton giant cells consist of fused epithelioid macrophages and have multiple nuclei. They are characterized by the ring-shaped arrangement of their nuclei and the presence of foamy cytoplasm surrounding the nucleus. Touton giant cells have been observed in lipid-laden lesions such as fat necrosis.
The granulomatous tissue largely comprises foam cells of monocyte/macrophage origin positive for KP1, HAM56, CD11b and CD68. Neutrophils, hemorrhagic foci and numerous plasma cells are additional findings.
PAS diastase stain is also used in diagnosing Whipple’s disease, as the foamy macrophages that infiltrate the lamina propria of the small intestine in this disease possess PAS-positive, diastase-resistant inclusions. [3]
The connective tissue of the lamina propria is loose and rich in cells. The cells of the lamina propria are variable and can include fibroblasts, lymphocytes, plasma cells, macrophages, eosinophilic leukocytes, and mast cells. [2] It provides support and nutrition to the epithelium, as well as the means to bind to the underlying tissue.
Staining macrophages in Whipple's disease. [3] It can be used to diagnose α1-antitrypsin deficiency if periportal liver hepatocytes stain positive. Aggregates of PAS-positive lymphocytes are present in epidermis in Mycosis fungoides and Sézary syndrome, called Pautrier microabscesses. Ewing sarcoma; Erythroleukemia, a leukemia of immature red ...