N. Balachander, E. Rajesh, S. Hari Priya and K. M. K. Masthan

Department of Oral Pathology, Sree Balaji Dental College and Hospital, Bharath University, Pallikaranai, Chennai-600100.

DOI : https://dx.doi.org/10.13005/bpj/1013

Abstract

The pathology studies widely deal with many cellular and nuclear altered structures other than these one of the important and interesting features is the observation of various histopathological bodies. These inclusion bodies is an important diagnostic-aid in identifying the underlying disease. Therefore in this article present different inclusion bodies seen in various diseases.

Keywords

histopathologica; diagnostic-aid ; pathology

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Copy the following to cite this article: Balachander N, Rajesh E, Priya S. H, Masthan K. M. K. Inclusion Bodies. Biomed Pharmacol J 2016;9(2).

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Introduction

Inclusion bodies are nuclear or cytoplasmic aggregates which are stainable substances, usually proteins, and formed due to viral multiplication or genetic disorders in human beings these bodies are either intracellular or extracellular abnormalities and they are specific to certain diseases.  When a foreign gene or the infectious agent is injected into a cell, the complementary DNA translated from a messenger RNA may code for a protein, which are fails to undergo further modification, transport, condensation of the cell, result in inclusion body. In some diseased conditions, cells modified and may become pathognomonic for that particular disease.

Classification Of Inclusion Bodies¹

Physiological inclusion bodies

Infection inclusion bodies

Inclusion bodies in viral condition

Intra cytoplasmic inclusions

Intra nuclear inclusions

Inclusion Bodies seen in bacterial infections.

Inclusion Bodies seen in fungal infections.

Inclusion bodies in neoplasms.

Inclusion bodies in autoimmune diseases.

Inclusion bodies seen in blood dyscrasias.

Inclusion bodies seen in cystic lesions.

Physiological inclusion bodies

Odland bodies

In Keratinized stratified squamous epithelium is shows membrane-coating granules called Odland bodies. It is also called as lamellar bodies, keratinosomes. These are seen in the upper stratum spinosum and stratum granular cell layers which are rich in glycolipids. These lipids are discharged extracellularly to form a permeability barrier that prevent absorption of aqueous fluids.^[2]

Weibel Palade bodies

They are Storage granules of endothelial cells, von Willebrand factor and P-selectin are two principal molecules are stored in the bodies released when needed. Thus its play important role in haemostasis and inflammation. Infection inclusion bodies.^[3]

Infection inclusion bodies

nclusion bodies in viral condition

Intra cytoplasmic inclusions

Councilman Bodies^[6]

Described → they were named by an American Pathologist William T. Councilman as they called by his name ‘Councilman Bodies’.

Type →acidophilic inclusion bodies

Morphology → cytoplasm of hepatocytes, with ballooning degeneration. This is due to hepatocytes undergoing apoptosis.

Diseases → viral infections such as viral hepatitis and yellow fever.

Henderson Peterson bodies^[7]

Type → intracytoplasmic inclusions

Diseases → Molluscum Contagiosum disease caused by Pox viruses spinous and corneum of the infected epithelium

Morphology → large ellipsoid, homogenous, which are nuclear and cytoplasmic aggregates bodies.

Intra nuclear inclusions

Cowdry Type- A^[8,9]

Diseases → gingivostomatitis and conjunctivitis caused by herpes simplex and also chicken pox caused by varicella zoster. These bodies

Morphology → acidophilic material of droplet-like masses surrounded by clear halos within nuclei.

Lipschutz bodies^[10]

Type → eosinophilic nuclear inclusions

Morphology → enlarged nuclei and clear halo

Diseases →  varicella zoster and herpes simplex

Cowdry Type- B^[11]

Type →  intranuclear eosinophilic without any nuclear change

Morphology → amorphous or droplet like bodies surrounded by clear halo in diseases like amorphous or droplet like bodies surrounded by clear halo infection.

‘Owl’s eye’^[12]

Type → they are large intranuclear viral inclusion bodies with thickened nuclear membrane

Morphology → appear owl’s eye

Diseases →  Hodgkin’s lymphomas

Inclusion Bodies seen in bacterial infections.

Dohle bodies^[4,5]

Morphology → light blue-grey, oval, basophilic staining areas in the cytoplasm of neutrophils shows defect in maturation of neutrophils.

Diseases → typhoid, diphtheria,and tuberculosis.

Stain → Leishman-Giemsa stain and Romanowsky stain.

Inclusion Bodies seen in fungal infections.

Asteroid bodies^[13,14]

Morphology → stellate shape with numerous rays radiating from the central core.

Diseases → Sporotrichosis

‘Toto bodies

Morphology → homogeneous, eosinophilic pools of material seen in superficial spinous layer of the surface epithelium

Diseases → epulis fissuratum.

Inclusion bodies in neoplasm.

Wagner- Meissner body^[15,16]

Morphology → oval aggregates of eosinophilic globules containing parallel slits

Diseases → von Recklinghausen’s disease of skin, neurofibroma

Verocay bodies

Morphology → arranged spindle shaped cells with a palisading pattern

Diseases → benign nerve sheath tumor, Schwannoma

Psammoma bodies^[17,18]

Morphology →  spherical, concentrically laminated mass of calcified material these bodies are formed due to necrosis followed by dystrophic calcification.

Diseases → numerous benign and malignant epithelial and connective tissue tumors such as psammomatoid meningioma, psammomatoid juvenile ossifying fibroma, psammomatoid melanotic schwannoma, cystadenocarcinoma.

Stain → H&E stain

Russell bodies

Described →  Michaels (1935)

Diseases →  chronic inflammatory granulomata, multiple myeloma, plasmacytoma, helicobacter pylori infection, periapical granuloma.

Stain →  GrunwaldGiemsa stain, fibrin, periodic acid Schiff

Pustulo- Ovoid bodies^[19-21]

Type → eosinophilic inclusions

Morphology → round by aggregation coalescing granules

Diseases → granular cell tumors

Kamino bodies

Type → eosinophilic inclusion bodies

Morphology →  globules

Diseases → pigmented spindle cell nevus, Spitz nevus

Stain →  trichrome stains and periodic Acid- Schiff’s

Dutcher bodies

Described → Dutcher and Fahey

Type → intranuclear inclusions

Morphology → smooth, membrane-bound and surrounded by clumped chromatin, immunoglobulin protein.

Diseases → chronic synovitisandlarge B- cell lymphoma and multiple myeloma.

Stain → Wright- Giemsa stains and periodic acidSchiff’s

Inclusion Bodies in autoimmune diseases.^[1]

Civatte bodies

Type→ eosinophilic

Morphology →  waverly arranged fine filaments entangledwith desmosomes, melanosomes, and other organelles.

Diseases→ discoid lupus erythematosus and lichen planus

Formation→due to basal cell liquefaction degeneration and hypergranulosis

Derivation→ basal cells and connective tissue elements from the basement membrane zone

Stain→ for keratin

Hematoxylin bodies

Type→ basophilic extracellular aggregation

Morphology→ ovoid in shape, necrotic loci and contain densechromatin

Diseases→ systemic lupus erythematous

‘Schaumann bodies

Described→ Jorge Schaumann in 1941

Morphology→ large concentrically lamellated structure seen in the cytoplasm of the giant cells, presence of calcium and phosphorus and small quantities of iron in Schaumann bodies

Diseases→ Sarcoidosis, tuberculosis, hypersensitive pneumonitis

These inclusion bodies enlarge within the and giant cells and macrophages later  rupture the cytoplasmic membrane of cell appear in extra cellular matrix excluded crystals underwent further deposition of minerals leading to extracellular calcifications.

Inclusion bodies seen in blood dyscrasias.^[1]

Heinz bodies

Described→ Robert Heinz in 1890

Morphology→ irregular, small, deep purple granules in red blood corpuscles

Diseases→ Glucose-6-phosphate dehydrogenase deficiency, haemolytic anemias, hemolytic anemias

Stain→ Wright’s stain and crystal violet

Formation→ oxidative damage of DNA or change in aminoacids morphology in RBC

Howell- Jolly bodies

Described → William Henry Howell and Justin Marie Jolly

Morphology→  dark staining small round inclusions and ring like appearance in the red blood corpuscles – mimics parasites

It is presented as remnant of DNA during its maturation in bone marrow

Diseases→ Pernicious anemia and Leukaemia with megaloblastic anemia

Inclusion bodies seen in cystic lesions^[1]

Rushton bodies/ Hyaline bodies

Two Types→ eosinophilic granular core and concentrically lamellatedsome hyaline bodies are partly lamellar and partly granular

Morphology→ various shape linear, curved, hairpin shaped, straight, circular or polycyclic forms.Mostly seen in the epithelial lining and rarelyin fibrous capsule

Ultrastructure→ two forms- lamellated and homogeneous is composed of outermost electron dense and electron lucent layers

Stain→  Mallory aldehyde fuchsin, periodic acid-Schiff, Gomori stains, Papanicolaou and Orcein.

Diseases→  Plexiform Ameloblastoma, Residual Cyst and Radicular Cyst.

Conclusion

Disease progression occurs with biochemical and cellular changes. Presence of inclusion bodies indicates disease. Absence of them indicates the disease subsidence. Inclusion bodies in the course of the disease at various stages is used in staging the diseases and for their treatment planning.

Reference

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