Persistent polyclonal B-cell lymphocytosis with buttock-like cells mimicking follicular lymphoma.

IF 2.3 Q2 HEMATOLOGY

Blood Research Pub Date : 2023-09-30 Epub Date: 2023-07-24 DOI:10.5045/br.2023.2023116

Fnu Aakash, Sa A Wang, Karan Saluja, Beenu Thakral

{"title":"Persistent polyclonal B-cell lymphocytosis with buttock-like cells mimicking follicular lymphoma.","authors":"Fnu Aakash, Sa A Wang, Karan Saluja, Beenu Thakral","doi":"10.5045/br.2023.2023116","DOIUrl":null,"url":null,"abstract":"A 52-year-old woman was found to have leukocytosis [19.4×10 9 /L (range, 4 – 11)] with absolute lymphocytosis [5.8×10 9 /L (range, 1 – 4.8)] for ∼ 1 year. Peripheral blood (PB) showed circulating atypical, binucleated and clefted lymphocytes mimicking “buttock cells” of follicular lymphoma. PB flow cytometry (FC) showed polytypic B-cell lymphocytosis (64.4%) expressing CD19 + CD20 + CD27 + IgM + and CD5 - CD10 - CD38 - . No cutaneous lesions were noted. A staging bone marrow showed no evidence of lymphoma. Cytogenetics showed a normal female karyotype. Serum IgM levels were increased [8.4 g/L (range, 0.35 – 2.4)], with normal IgA and IgG levels. Serum protein electrophoresis and immunofixation studies showed no M-protein. PET-CT showed no lymphadenopathy or hepatosplenomegaly. She had 30-years smoking history. Based on the above findings, persistent polyclonal B ‐ cell lymphocytosis (PPBL) was diagnosed. PPBL is a benign proliferation of memory B-cells in adult women with longstanding smoking history. Exact pathogenesis of PPBL is not known, potential mechanisms include defect in CD40 activation pathway or expansion of functional CD27 + memory B-cells. About 90% of PPBL cases are HLA-DR7-positive","PeriodicalId":46224,"journal":{"name":"Blood Research","volume":" ","pages":"125"},"PeriodicalIF":2.3000,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/8a/br-58-3-125.PMC10548282.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5045/br.2023.2023116","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/24 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

A 52-year-old woman was found to have leukocytosis [19.4×10 9 /L (range, 4 – 11)] with absolute lymphocytosis [5.8×10 9 /L (range, 1 – 4.8)] for ∼ 1 year. Peripheral blood (PB) showed circulating atypical, binucleated and clefted lymphocytes mimicking “buttock cells” of follicular lymphoma. PB flow cytometry (FC) showed polytypic B-cell lymphocytosis (64.4%) expressing CD19 + CD20 + CD27 + IgM + and CD5 - CD10 - CD38 - . No cutaneous lesions were noted. A staging bone marrow showed no evidence of lymphoma. Cytogenetics showed a normal female karyotype. Serum IgM levels were increased [8.4 g/L (range, 0.35 – 2.4)], with normal IgA and IgG levels. Serum protein electrophoresis and immunofixation studies showed no M-protein. PET-CT showed no lymphadenopathy or hepatosplenomegaly. She had 30-years smoking history. Based on the above findings, persistent polyclonal B ‐ cell lymphocytosis (PPBL) was diagnosed. PPBL is a benign proliferation of memory B-cells in adult women with longstanding smoking history. Exact pathogenesis of PPBL is not known, potential mechanisms include defect in CD40 activation pathway or expansion of functional CD27 + memory B-cells. About 90% of PPBL cases are HLA-DR7-positive

Abstract Image