[Polyclonal lymphocytosis with binucleated lymphocytes. Morphological, immunological, cytogenetic and molecular analysis in 15 cases].
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.
Troussard
X
X
Laboratoire d'Hématologie, CHU Côte de Nacre, Caen.
Mossafa
H
H
Valensi
F
F
Maynadie
M
M
Schillinger
F
F
Bulliard
G
G
Malaure
H
H
Flandrin
G
G
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
D007075:Immunoglobulin M
Lymphocytose polyclonale avec lymphocytes sanguins binucléés. Analyse morphologique, immunologique, cytogénétique et moléculaire de 15 cas.