title: [Polyclonal B-cell lymphocytosis with hairy cell appearance: hairy B-cell lymphoproliferative disorder].
abstract: A 72-year-old woman was referred to our hospital for evaluation of leukocytosis revealed by a medical examination. Her physical examination demonstrated no splenomegaly and no palpable lymph nodes. Her white cell count was 10,900/microl with atypical lymphocytosis (84.5%). Her hemoglobin concentration was 10.4 g/dl, and platelet count 151,000/microl. On peripheral blood smears, the atypical lymphocytes had a hairy cell-like appearance, and phase-contrast microscopic and transmission electron microscopic findings revealed the lymphocytes had many long surface microvilli. Flowcytometric analysis of peripheral blood lymphocytes identified expanded B-lymphocytes as having the IgG+, CD5- CD10- CD11c+ CD19+ CD20+ CD23- CD25- and CD103- cell surface phenotype. Serum electrophoresis disclosed polyclonal elevation of IgG and IgM (2620 mg/dl and 840 mg/dl, respectively). No light-chain restriction and a polyclonal VH gene rearrangement pattern indicated the polyclonal proliferation of B cells. The patient was a nonsmoker and had HLA-DR4, as in previous reports which have suggested an association between hairy B-cell lymphoproliferative disorder (HBLD) and HLA-DR4. No chromosome 3 abnormality was observed. These findings were consistent with the characteristics of HBLD, but differed in some respects from those of persistent polyclonal B-cell lymphocytosis (PPBL). Therefore, we diagnosed this patient as having HBLD.
authors.affiliation: Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Nakahashi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Arito
authors.initials: A
authors.lastname: Yamane
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Irisawa
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yokohama
authors.forename: Takayuki
authors.initials: T
authors.lastname: Saitoh
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hanada
authors.forename: Takafumi
authors.initials: T
authors.lastname: Matsushima
authors.forename: Norifumi
authors.initials: N
authors.lastname: Tsukamoto
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Karasawa
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Murakamai
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nojima
mesh_terms: D000368:Aged; D001402:B-Lymphocytes / Q000473:pathology*; D005260:Female; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000473:pathology*