Large cell lymphoma complicating persistent polyclonal B cell lymphocytosis.

Abstract

Persistent polyclonal B cell lymphocytosis (PPBL) is a rare lymphoproliferative disorder of unclear natural history and its potential for B cell malignancy remains unknown. We describe the case of a 39-year-old female who presented with stage IV-B large cell lymphoma 19 years after an initial diagnosis of PPBL; her disease was rapidly fatal despite intensive chemotherapy and blood stem cell transplantation. Because we had recently identified multiple bcl-2/Ig gene rearrangements in blood mononuclear cells of patients with PPBL, we sought evidence of this oncogene in this particular patient: bcl-2/Ig gene rearrangements were found in blood mononuclear cells but not in lymphoma cells. Owing to the possible role of Epstein-Barr virus (EBV) in the pathogenesis of PPBL, we also hypothesized our patient might have an EBV-related lymphoproliferative disorder. Despite serologies consistent with past exposure to this virus, it was not found in lymphoma cells using a sensitive polymerase chain reaction technique. We conclude that non-Hodgkin's lymphoma may occur during the course of PPBL. However, longer follow-up in more patients will be needed in order to better clarity the risk of hematologic malignancy in patients with PPBL.

• Authors: J Roy, C Ryckman, V Bernier, R Whittom, R Delage
• Journal: Leukemia (Leukemia) Vol. 12 Issue 7 Pg. 1026-30 (Jul 1998) ISSN: 0887-6924 [Print] England
• PMID: 9665185 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Adult
• B-Lymphocytes (pathology)
• Biopsy
• Female
• Gene Rearrangement
• Genes, bcl-2
• Humans
• Immunohistochemistry
• Lymph Nodes (pathology)
• Lymphocytosis (complications, genetics, pathology)
• Lymphoma, B-Cell (etiology, genetics)
• Lymphoma, Large B-Cell, Diffuse (etiology, genetics, pathology)
• Polymerase Chain Reaction