title: [Polyclonal lymphocytosis with binucleated lymphocytes. Morphological, immunological, cytogenetic and molecular analysis in 15 cases].
abstract: OBJECTIVE
  Describe the clinical, immunological, cytogenetic and molecular aspects of polyclonal lymphocytosis with binucleated peripheral lymphocytes in order to ascertain the therapeutic consequences.
  
  
  METHODS
  Fifteen patients, 13 women, 2 men, with a total lymphocyte count persistently above 4 x 10(9)/l at successive counts and binucleated lymphocytes on blood smears were studied.
  
  
  RESULTS
  The syndrome is easily recognized at careful examination of blood smears which show binucleated lymphocytes and lymphoid cells with heterogeneous morphology. The lymphocytosis is polyclonal. The clinical situation remains stable without treatment despite cytogenetic clonality which contrasts with molecular polyclonality.
  
  
  CONCLUSIONS
  Polyclonal lymphocytosis with binucleated lymphocytes is a clinical entity characterized by 1) nearly exclusive female predominance, mainly in young smokers; 2) lymphocyte counts above 4 x 10(9)/l which persist (> 6 months), are unchanged over time and fortuitously discovered; 3) lymphocytosis with binucleated lymphocytes on blood smears; 4) polyclonal lymphocytosis; 5) increased polyclonal serum IgM; and 6) recurrent cytogenetic anomalies with an isochromosome supenumerary marker, e.g. +i (3q). The etiology remains unknown: the role of smoking genetic predisposition or viral factors remains to be determined.
authors.affiliation: Laboratoire d'Hématologie, CHU Côte de Nacre, Caen.
authors.forename: X
authors.initials: X
authors.lastname: Troussard
authors.forename: H
authors.initials: H
authors.lastname: Mossafa
authors.forename: F
authors.initials: F
authors.lastname: Valensi
authors.forename: M
authors.initials: M
authors.lastname: Maynadie
authors.forename: F
authors.initials: F
authors.lastname: Schillinger
authors.forename: G
authors.initials: G
authors.lastname: Bulliard
authors.forename: H
authors.initials: H
authors.lastname: Malaure
authors.forename: G
authors.initials: G
authors.lastname: Flandrin
mesh_terms: D000328:Adult; D015139:Blotting, Southern; D003582:Cytogenetics; D005260:Female; D005500:Follow-Up Studies; D015321:Gene Rearrangement; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D016130:Immunophenotyping; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology*; D008218:Lymphocytosis / Q000097:blood* / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D013577:Syndrome
chemical_list: D007075:Immunoglobulin M
vernacular_title: Lymphocytose polyclonale avec lymphocytes sanguins binucléés. Analyse morphologique, immunologique, cytogénétique et moléculaire de 15 cas.