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Related Experiment Videos

Persistent polyclonal lymphocytosis with binucleated B lymphocytes: a genetic predisposition

X Troussard1, F Valensi, C Debert

  • 1Laboratoire d'Hématologie, Hôpital Necker-Enfants Malades, Paris, France.

British Journal of Haematology
|October 1, 1994
PubMed
Summary

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This study identifies a benign syndrome of chronic lymphocytosis with atypical binucleated lymphocytes in women. Recognizing this condition prevents misdiagnosis as malignant lymphoproliferative disease.

Area of Science:

  • Hematology
  • Immunology
  • Genetics

Background:

  • Persistent lymphocytosis often indicates malignant lymphoproliferative disease (MLPD).
  • Atypical lymphocytes on peripheral blood smears can be a diagnostic challenge.
  • Distinguishing benign from malignant causes of lymphocytosis is critical for patient management.

Purpose of the Study:

  • To describe a unique syndrome of chronic, moderate lymphocytosis in six female patients.
  • To investigate the characteristics of atypical binucleated lymphocytes and associated immunological markers.
  • To highlight the importance of identifying this benign condition to avoid misdiagnosis of MLPD.

Main Methods:

  • Peripheral blood smear analysis for lymphocyte morphology.
  • Serum immunoglobulin quantification (IgM).

Related Experiment Videos

  • Human Leukocyte Antigen (HLA) typing for HLA-DR7 phenotype.
  • Molecular genetic analysis (Southern hybridization, PCR) for immunoglobulin heavy chain gene rearrangement to assess B cell clonality.

    • Main Results:

    • All six patients exhibited chronic, moderate lymphocytosis (2-16 years) with atypical binucleated lymphocytes.
    • A polyclonal increase in serum IgM and the presence of HLA-DR7 phenotype were observed in all patients.
    • Molecular studies confirmed polyclonal B cells, ruling out MLPD.
    • Binucleated lymphocytes were noted in family members of two patients, suggesting a genetic predisposition.

    Conclusions:

    • A benign syndrome characterized by chronic lymphocytosis, atypical binucleated lymphocytes, polyclonal B cells, and association with HLA-DR7 is identified.
    • The presence of binucleated lymphocytes in family members suggests a potential genetic component.
    • Accurate diagnosis of this benign syndrome is crucial to prevent unnecessary treatment for presumed malignant lymphoproliferative disease.