Electron microscopy of chronic eosinophilic pneumonia.
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We have investigated two cases of chronic eosinophilic pneumonia using the electron microscope. The alveolar septa were thickened due to edema and an infiltrate of numerous mononuclear cells and eosinophils, with a few lymphocytes and occasional plasma cells. Macrophages were often located close to eosinophils and extracellular eosinophilic granules. Occasional eosinophilic granules were observed in the cytoplasm of mononuclear cells. The most striking finding was the presence of distinctive elongated, narrow, tubular inclusions in the cytoplasm of several of the mononuclear cells. These inclusions presented complex curved profiles which sometimes terminated in small, dilated, dense vesicles. Some of the narrow tubular sections of the inclusions presented a pentalaminar structure. Elsewhere, the tubular structures showed localized globular dilatations which contained granular material. Elongated strands of electron-dense material, identical to that forming the intracytoplasmic inclusions, were also located extracellularly, between adjacent mononuclear cells and between mononuclear cells and eosinophils. These inclusions are considered to be the product of phagocytosis of cellular debris and to be related to phagolysosomes rather than to Birbeck granules.
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