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Parallel tubular inclusions were found in peripheral blood lymphocytes from 18 patients with various hematologic disorders, primarily lymphoproliferative processes, and 1 apparently healthy individual. The inclusions varied in size from 1000 to 6000 A and were usually membrane bounded. The microtubule-like structures comprising the inclusions ranged in size from 150 to 300 A and were packed in wall-to-wall contact with each other. Dense amorphous material and small dark crystalloids were frequently noted in the inclusions. There appeared to be a spatial and structural relationship of the inclusions with the centriole. The highest percent of lymphocytes with inclusionss (greater than 90%) were found in a patient with a lympho-proliferative disorder in whom 95% of the peripheral blood lymphocytes typed as T cells by spontaneous rosette formation with sheep red blood cells. (Am J Pathol 78:59-70, 1975)

The ultrastructural cellular inclusions referred to as ribosome-lamella complexes were observed in the neoplastic cell population of 4 patients with three types of hematopoietic malignancy, monoblastic leukemia. Waldenstrom's macroglobulinemia, and chronic lymphatic leukemia. The ultrastructural characteristics of the inclusions were similar in the 4 cases. The percentage of cells affected ranged from approximately 90% in 1 patient with monoblastic leukemia to approximately 10% in a patient with Waldenstrom's macroglobulinemia. The complexes appeared to originate from the rough endoplasmic reticulum. Observations suggested a developmental sequence beginning with aggregate strands of rough endoplasmic reticulum, subsequent alignment of the strands of rough endoplasmic reticulum in a concentric configuration, followed by maturation to fully developed ribosome-lamella complexes. Although the ribosome-lamella complex has been found in the neoplastic cells of several patients with leukemic reticuloendotheliosis ("hairy cell leukemia"), its occurrence in these three different hematopoietic disorders indicates a lack of diagnostic specificity of this structure.