title: [Morphologic features of the binucleated lymphocytes for the assesment of persistent B-cell polyclonal lymphocytosis].
abstract: Observation of binucleated lymphocytes on a blood film is a cornerstone event to assess persistent polyclonal B-cell lymphocytosis diagnosis (PPBL). But seldom case reports mentioned their finding in other contexts, mainly B-cell lymphoproliferative neoplasms such chronic lymphocytic leukemia or in reactive circumstances as multiple sclerosis undergoing natalizumab treatment. We aimed to check if some particular morphologic features were more specificaly linked to PPBL, reviewing blood films of series of patients affected by PPBL or harbouring binucleated lymphocytes whatever the diagnosis was. We found that binucleated cells in PPBL were heterogeneous but mostly midde-sized cells, asymetricaly bilobed with nucleoli, and with a moderately basophilic cytoplasm. Though mainly observed in PPBL patients, all that criteria remained unspecific. Conversely, the morphologic features of the other lymphoid cells were of good clinical value to affirm PPBL, either monocytoid or hyperbasophilic cells being systematically found. We think that a substantial percentage of binucleated lymphocytes, harbouring morphologic features such as described, and in a context of monocytoid and/or hyperbasophilic lymphocytes is predictive of PPBL diagnosis.
authors.affiliation: Service d'hématologie biologique, CHU Brabois, Nancy, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Lesesve
authors.affiliation: Service d'hématologie biologique, CHU Brabois, Nancy, France.
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Gressot
authors.affiliation: Laboratoire d'hématologie, CHU Côte de Nacre, Caen, France.
authors.forename: Edouard
authors.initials: E
authors.lastname: Cornet
authors.affiliation: Département de génétique humaine, Laboratoire Pasteur-Cerba, Cergy-Pontoise, France.
authors.forename: Hossein
authors.initials: H
authors.lastname: Mossafa
authors.affiliation: Laboratoire d'hématologie, CHU Côte de Nacre, Caen, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Troussard
mesh_terms: D001402:B-Lymphocytes / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology*; D048750:Cell Nucleus Division; D048430:Cell Shape; D003581:Cytodiagnosis / Q000379:methods; D003937:Diagnosis, Differential; D006801:Humans; D008218:Lymphocytosis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology*; D008232:Lymphoproliferative Disorders / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D009103:Multiple Sclerosis / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D012189:Retrospective Studies; D014777:Virus Diseases / Q000097:blood / Q000175:diagnosis / Q000473:pathology
keywords: binucleated lymphocyte; lymphocyte morphology; persistent B-cell lymphocytosis