Bilobulated circulating lymphocytes in persistent polyclonal B-cell lymphocytosis.
نویسندگان
چکیده
Correspondence: Lourdes Florensa, MD, Laboratori de Citologia Hematològica, Laboratori de Referència de Catalunya, Hospital de l’Esperança, Av. Sant Josep de la Muntanya 12, 08024 Barcelona, Spain. Phone: international +34-93-285.02.00 ext 2189-2243 – Fax: international +34-93-210.84.06 – E-mail: [email protected] A44-year-old female was referred for investigation of a 10-year persistent lymphocytosis. The patient was a heavy smoker. On physical examination no organomegaly was detected. Complete blood counts showed: hemoglobin 11g/dL, platelets 2193109/L, leukocytes 10.33109/L, 47% segmented neutrophils, 1% band forms, 48% lymphocytes,1% monocytes, 2% eosinophils and 1% basophils. Serum IgM was increased (794 mg/dL) but without a peak. Serum IgG and IgA were normal to slightly decreased. HLA-DR typing expressed DR3, DR7, DRw52 and DRw53. Blood chemistry was normal. Microscopic blood smear examination revealed 10% of lymphocytes with a binucleated or bilobulated nucleus connected sometimes by a slender internuclear bridge (Figure 1). The most striking nuclear abnormality was nuclear pockets found in 6 of 25 sections of mainly bilobulated lymphocytes (Figure 2). Bone marrow aspirate was normal. Immunophenotyping of peripheral atypical lymphocytes revealed CD19+, HLA-DR+, IgM+, CD3–, CD5–, CD23–. Both k and l light chains were expressed indicating the polyclonal nature of the B-lymphocytes. FISH studies demonstrated the presence of three spots corresponding to three centromers of chromosome 3. Bilobulation of lymphocytes is the morphologic hallmark of persistent polyclonal B lymphocytosis, an indolent disorder associated with HLA-DR7, a polyclonal increase in IgM and sometimes an additional i(3)(q10) as cytogenetic abnormality.1,2
منابع مشابه
Persistent polyclonal B-cell lymphocytosis.
We document a case of persistent lymphocytosis in which the characteristic binucleated circulating lymphocytes were shown immunologically to be polyclonal B-cells. Cytogenetic and molecular studies failed to show a clonal population. A review of the literature on this rare condition, persistent polyclonal B-cell lymphocytosis, highlights an association with the female sex, HLA-DR7 antigen, smok...
متن کاملModifications in B-Lymphocyte Number and Phenotype in the Course of Pregnancy in a Woman with Persistent Polyclonal B-Cell Lymphocytosis: A Flow Cytometric Study.
Persistent polyclonal B-cell lymphocytosis (PPBL) is a rare clinical condition, characterized by a persistent, generally moderate lymphocytosis, generally due to stimulation of central memory B-lymphocytes, and by a moderate increase of polyclonal IgM. In some patients, slight or moderate splenomegaly is observed. A variable percentage of circulating, bone marrow and splenic lymphocytes display...
متن کاملNo BCL-2 protein over expression but BCL-2/IgH rearrangements in B cells of patients with persistent polyclonal B-cell lymphocytosis.
INTRODUCTION Persistent polyclonal B-cell lymphocytosis is a rare hematological disorder, characterized by a chronic, stable and absolute polyclonal lymphocytosis, the presence of binucleated lymphocytes, a polyclonal increase in serum IgM immunoglobulin and clonal cytogenetic abnormalities involving chromosome 3. For explaining the expansion of B-lymphocytes pool in PPBL, an association with c...
متن کاملHistological and immunohistochemical features of the spleen in persistent polyclonal B-cell lymphocytosis closely mimic splenic B-cell lymphoma
UNLABELLED Persistent polyclonal B-cell lymphocytosis (PPBL) is rare and intriguing hematological disorder predominantly reported in young to middle- aged smoking women. It is characterized by persistent moderate polyclonal B-cell lymphocytosis with circulating hallmark binucleated lymphocytes and elevated polyclonal serum IgM. Most patients have benign clinical course on long-term follow-up. S...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Haematologica
دوره 84 8 شماره
صفحات -
تاریخ انتشار 1999