THE ORIGIN AND FATE OF TWO TYPES OF MULTI-NUCLEATED GIANT CELLS IN THE CIRCULATING BLOOD

1. It has been demonstrated that giant cells of the foreign body and epithelioid types can be induced to appear in the blood stream. 2. Evidence has been presented which indicates that foreign body giant cells are primarily formed by fusion of monocytes and that the fate of these giant cells is accomplished, at least in some instances, by a separation into the constituent elements. 3. Further evidence has been presented which lends support to the hypothesis that "epithelioid giant cells" reach their stage of evolution, not by fusion of monocytes, but by amitotic division of the nuclei of monocytes and epithelioid cells. 4. The presence of giant cells in the peripheral blood as the result of agar injections is almost invariably associated with, or preceded by a marked monocytosis in which the new monocytes are of large size and show evidence of immaturity. 5. Injections of agar into the tissues result in decreased absolute and percentage values of lymphocytes and a diminution of the specific granules in many of the polymorphonuclear leucocytes. 6. It would appear from these studies that a clear differentiation of "epithelioid giant cells" and "foreign body giant cells" in the blood is usually possible, but that on the other hand, a few cells may be present which have some of the characteristics of each type. These latter cells probably represent in their formation both a fusion of individual cells and an amitotic division of the nuclei of monocytes. 7. Clasmatocytes or macrophages have in rare instances been seen to take part in the formation of foreign body giant cells. At least one instance has been noted of the fusion of a clasmatocyte with several monocytes. No evidence is available to demonstrate that macrophages ever play a part in the formation of "epithelioid giant cells."