Phospholipid accumulation in histiocytes of splenic pulp associated with thrombocytopenic purpura.

CCUMULATION of lipid, presumably phospholipid, in histiocytes of the splenic cords has been seen in association with thrombocytopenic purpura in six patients operated on in Barnes Hospital. At the time that each of the first four were examined, a diagnosis or description of lipid histiocytosis of the spleen was made, but after that the constant association with thrombocytopenic purpura was noted. Three of the cases were seen between November of 1958 and November of 1959, a fourth in September 1960, and the fifth and sixth were located by review of sections of all 737 spleens removed or biopsied ill Barnes Hospital from 1922 through 1960. Five of the six patients had otherwise typical idiopathic thrombocytopenia; the sixth had amegakaryocytic thrombocytopenia. A seventh case, similar in most respects, which was reported by Carpenter et. tI.: has been included in this report as Case 7. These authors excluded one case from their group of cases of idiopathic thrombocytopenic purpura l)ecause it showed “. . . an abnormality not usually encountered in ITP; e.g., . . . infiltration of the spleen by non-lipid containing macrophages.” Review of the sections of the spleen in this case showed the same lesion as in our six cases, except that very little stainable lipid was found.