Nurse like cells: chronic lymphocytic leukemia associated macrophages.
CD14 + cells are able to differentiate into large and adherent cells if in contact with chronic lymphocytic leukemia (CLL) cells or healthy B lymphocytes. In CLL these cells, called CLL-nurse like cells (NLCs), express a very high amount of CD163 and CD68 and are able to rescue CLL cells through CCL4 production. Adherent cells derived from healthy donors, called HD-NLCs, express very little CD163 and CD68, do not produce CCL4 and are unable to rescue CCL cells. This study reveals that CLL-NLCs are the specific nurse cells in CLL, protecting CLL cells from death.
The case of a 15 year old girl with a rapidly progressing right sided hemiparesis is reported. The history and clinical manifestations were suggestive of either herpes simplex encephalitis or occlusion of the left middle cerebral artery. At necropsy an occlusive thrombosis of the left middle cerebral artery due to a segmental necrotizing granulomatous panarteritis was found. The cause was obscure. A plausible incriminating factor was the contraceptive pill.