Epithelioid germinal centers in overwhelming childhood infections. The aftermath of nonspecific destruction of follicular B cells by natural killer cells

G. S. Severson, D. S. Harrington, Sonny Lennart Johansson, B. M. McManus

Research output: Contribution to journalArticle

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Abstract

The destruction of proliferating lymphoid cells within germinal centers with subsequent replacement by histiocytoid cells has been described in infants and children dying of viral and bacterial infections. The etiology and significance of 'epithelioid germinal centers' (EGCs) are unknown. The cells implicated in forming EGCs have included histiocytes and dendritic reticulum cells. We have studied four children at autopsy who died at ages ranging from 10 months to 7 years. Three contracted fatal infections, one with fulminant meningococcemia, one with bacterial sepsis, and one with viral hepatitis. The fourth child contracted viral pneumonitis and died of acetaminophen toxicity. Epithelioid germinal centers were found in numerous lymphoid organs (spleen, lymph nodes, and Bayer's patches) in all four cases. Avidin-biotin complex immunohistochemical analysis performed on formalin-fixed splenic tissue from the first three cases and snap-frozen splenic tissue from the second case revealed an absence of B cells in the follicular centers. The mantle zones surrounding follicles were thin but intact. The histiocytoid cells expanding the germinal centers were positive for S100 and R4/23 (dendritic reticulum cells) and negative for numerous histiocyte markers (α1-antitrypsin, α1-antichymotrypsin, and lysozyme). Increased numbers of killer cells (Leu-7) were present within the affected germinal centers in the three cases in which material was available for immunohistochemical studies. Overwhelming infections in these patients seem to result in anomalous natural killer cell activation resulting in localized nonselective destruction of follicular centers similar to anomalous natural killer cell activity reported to occur in fatal infectious mononucleosis. This may lead to an acquired immunodeficiency that precludes long-term survival in affected patients.

Original languageEnglish (US)
Pages (from-to)917-921
Number of pages5
JournalArchives of Pathology and Laboratory Medicine
Volume112
Issue number9
StatePublished - Jan 1 1988

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Germinal Center
Natural Killer Cells
B-Lymphocytes
Infection
Reticulum
Histiocytes
Dendritic Cells
Infectious Mononucleosis
Avidin
Virus Diseases
Acetaminophen
Muramidase
Biotin
Bacterial Infections
Formaldehyde
Hepatitis
Autopsy
Sepsis
Pneumonia
Spleen

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Epithelioid germinal centers in overwhelming childhood infections. The aftermath of nonspecific destruction of follicular B cells by natural killer cells. / Severson, G. S.; Harrington, D. S.; Johansson, Sonny Lennart; McManus, B. M.

In: Archives of Pathology and Laboratory Medicine, Vol. 112, No. 9, 01.01.1988, p. 917-921.

Research output: Contribution to journalArticle

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