(1) The disease has classic histopathologic features consisting of Mikulicz cells, Russell bodies, and gram-negative bacilli.
Mikulicz cells are rarely identified; however, they can still be seen.
Mikulicz cells were characterized as atypical monocytes recruited from the bone marrow in a C-C chemokine receptor 2 (CCR2)-independent fashion.
Given the morphologic appearance of Mikulicz cells, one must consider various histiocytic lesions, such as Rosai-Dorfman disease and Erdheim-Chester disease.
Concern for an infectious etiology and/or histologic identification of Mikulicz cells should warrant tissue and blood cultures.
A novel murine model of rhinoscleroma identifies Mikulicz cells, the disease signature, as IL-10 dependent derivatives of inflammatory monocytes.
Histologically granulomatous tissue infiltrates the submucosa and is characterized by the presence of plasma cells, lymphocytes and eosinophils among which are scattered large foam cells (mikulicz cells
) (7) which have a central nucleus and vacuolated cytoplasm containing Frisch bacilli and russel bodies, the later resembling plasma cells and having eccentric nucleus and deep eosin- stained cytoplasm.
Biopsies reveal the characteristic finding of a submucosal lymphoplasmacytic infiltrate with large vacuolated histiocytes (Mikulicz cells
) containing the bacterial organisms.
Characteristic Mikulicz cells (foamy histiocytes) and plasma cells were seen in the sub epithelium (Fig.
(20) The disease is due to an altered immune response with impaired cellular immunity, leading to accumulation of distended phagosomes, called Mikulicz cells. The disease is common in North India.
Mikulicz noted its characteristic histologic features in 1877 (hence, the foamy histiocytes are named Mikulicz cells
It consists of a thickened hyperplastic mucosa, which frequently undergoes squamous metaplasia, with underlying intense granulomatous inflammation, numerous plasma cells with Russell bodies, and large foamy histiocytes known as "Mikulicz cells
" (Figures 1 and 2).