Pseudoactinomycotic radiate granules in the lower female genital tract: Relationship to the splendore-hoeppli phenomenon

Splendore-Hoeppli phenomenon, the in vivo formation of eosinophilic radiate structures around microorganisms and biologically inert substances, may simulate actinomycotic sulfur granules and has been recognized in extragenital sites. In the lower female genital tract, the authors have noted these pseudoactinomycotic radiate granules (PAMRAGs) in both the presence and the absence of intrauterine contraceptive devices. To elucidate the nature and morphogenesis of PAMRAGs, the light microscopic morphologic features of PAMRAGs were studied by means of a battery of special stains. The absence of central branching filaments or diphtheroid forms in PAMRAGs serves to distinguish them from true actinomycotic sulfur granules. Using the immunoperoxidase technique, the authors examined PAMRAGs for the presence of immunoglobulin, complement, and fibrin. Their studies showed that PAMRAGs contain neutral glycoproteins, lipid, and calcium with no demonstrable microorganisms, immunoglobulin, complement, or fibrin. The authors do not support the assertions of others that Splendore-Hoeppli radiate bodies are immune complexes derived from host serum proteins. They speculate that PAMRAGs of the genital tract are derived from host leukocytes that aggregate in response to the commonly present bacteria, parasites, or inert foreign bodies that initiate the Splendore-Hoeppli phenomenon and the morphogenesis of PAMRAGs.