Chronic B-cell lymphocytosis.
Persistent elevation of lymphocyte counts is usually associated with a malignant monoclonal lymphoproliferative disease. Over the last 8 years, amongst patients investigated in our center for undetermined persistent lymphocytosis, a diagnosis of malignant lymphoproliferation was excluded in 6 cases as studies of surface membrane immunoglobulin light chains showed that they presented a polyclonal expansion of their B-lymphocyte pool. All patients were young-to-middle aged women presenting peculiar immunohematologic findings characterized by 1) persistent (2-7 yr) elevation of lymphocyte counts (4-14 x 10(9)/l), 2) presence of characteristic binucleated B cells on peripheral blood smears, 3) a normal bone marrow histology, 4) a polyclonal increase of serum IgM with low-to-normal IgG and IgA levels. Histologic examination of the spleen in 2 patients and lymph nodes in 1 showed a benign follicular lymphoid hyperplasia. The evolution was benign in every case. We suggest that chronic polyclonal B-cell lymphocytosis is a distinct clinicopathologic entity that should not be confused with malignant lymphoproliferative disorders.
Perreault
C
C
Department of Hematology, Maisonneuve-Rosemont Hospital, Montreal, Canada.
Boileau
J
J
Gyger
M
M
de Bellefeuille
C
C
D'Angelo
G
G
Belanger
R
R
Lacombe
M
M
Lavallee
R
R
Bonny
Y
Y
Paquin
M
M
D000328:Adult; D001402:B-Lymphocytes / Q000473:pathology*; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007958:Leukocyte Count; D008198:Lymph Nodes / Q000473:pathology; D008218:Lymphocytosis / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D013154:Spleen / Q000473:pathology
D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M