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Chronic B-cell lymphocytosis.

C Perreault1, J Boileau, M Gyger

  • 1Department of Hematology, Maisonneuve-Rosemont Hospital, Montreal, Canada.

European Journal of Haematology
|April 1, 1989
PubMed
Summary
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Chronic polyclonal B-cell lymphocytosis is a distinct condition, not a malignant disease. This benign disorder in women features elevated lymphocytes and unique B cells, differing from cancerous lymphoproliferative disorders.

Area of Science:

  • Hematology
  • Immunology
  • Oncology

Background:

  • Persistent lymphocytosis often indicates malignant monoclonal lymphoproliferative disease.
  • Distinguishing benign from malignant causes of elevated lymphocyte counts is critical for patient management.

Purpose of the Study:

  • To describe a distinct clinicopathologic entity of chronic polyclonal B-cell lymphocytosis.
  • To differentiate this benign condition from malignant lymphoproliferative disorders.

Main Methods:

  • Analysis of 6 cases with unexplained persistent lymphocytosis over 8 years.
  • Evaluation of B-lymphocyte pool clonality using surface membrane immunoglobulin light chains.
  • Assessment of peripheral blood smears, bone marrow histology, and serum immunoglobulin levels.

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  • Histologic examination of spleen and lymph nodes in select cases.

    • Main Results:

    • Exclusion of malignant lymphoproliferation based on polyclonal B-cell expansion.
    • Consistent findings in affected patients: persistent lymphocytosis (4-14 x 10(9)/l), binucleated B cells, normal bone marrow histology.
    • Elevated serum IgM with normal IgG and IgA levels.
    • Benign follicular lymphoid hyperplasia observed in spleen and lymph node biopsies.
    • All cases demonstrated a benign clinical evolution.

    Conclusions:

    • Chronic polyclonal B-cell lymphocytosis represents a unique, benign clinicopathologic entity.
    • This condition should not be misdiagnosed as a malignant lymphoproliferative disorder.
    • Characteristic immunohematologic findings aid in its identification.