We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
RANDOX LABORATORIES

Download Mobile App




Events

ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.

Tissue Counterpart to Monoclonal B-Cell Lymphocytosis Characterized

By LabMedica International staff writers
Posted on 27 Dec 2021
Print article
Image: Blood film from a patient with Monoclonal B-cell lymphocytosis. The circulating atypical lymphocytes are mature with a small rim of basophilic cytoplasm. Monoclonal population of B cells in the blood is less than 5 ×109/L (Photo courtesy of Elizabeth Courville, MD)
Image: Blood film from a patient with Monoclonal B-cell lymphocytosis. The circulating atypical lymphocytes are mature with a small rim of basophilic cytoplasm. Monoclonal population of B cells in the blood is less than 5 ×109/L (Photo courtesy of Elizabeth Courville, MD)
Monoclonal B-cell lymphocytosis (MBL) was initially proposed to recognize patients with a monotypic B-cell population identified by peripheral blood (PB) flow cytometry (FC) that did not meet numerical criteria for chronic lymphocytic leukemia (CLL).

While MBL is defined in the blood, pathologists encounter rare cases in which a monotypic B-cell population is detected in biopsy tissue undergoing FC without obvious morphologic involvement by lymphoma. B-cell clones discovered in tissue biopsies, without overt lymphoma, may represent a tissue counterpart to peripheral blood monoclonal B-cell lymphocytosis (MBL), herein termed tMBL.

Hematopathologists at the Cleveland Clinic (Cleveland, OH, USA) searched for all cases from 2009 to 2019 with FC analysis demonstrating a monotypic B-cell population in which a corresponding lymphomatous infiltrate was not evident by re-review of the routine hematoxylin-eosin (H&E)–stained sections. Flow cytometry was performed in-house on 31 cases (BD FACSCanto, BD Biosciences, San Diego, CA, USA). At a minimum, all cases had immunohistochemical (IHC) stains for CD3, CD5, CD19, CD20, lymphoid enhancer-binding factor 1 (LEF1), and cyclin-D1. In cases with a clinical history of a CD10+ lymphoma, immunostaining with CD10, BCL2, and BCL6 was also performed.

The scientists reported that 54 cases were identified (35 lymph node, three splenic, and 16 soft tissue/viscera). Forty-six cases were chronic lymphocytic leukemia (CLL)-type, two were atypical CLL, and six were non-CLL. tMBL was detectable by immunohistochemistry in 14 cases (26%, all CLL-type). Concurrent blood flow cytometry, available in 10 cases, showed four with low-count MBL (three CLL-type, one with non-CLL–type), five with high-count MBL (all CLL-type), and one case negative for clonal population. With median follow-up of 51 months, two patients had progression of disease (CLL, 68.7 months; and diffuse large B-cell lymphoma, 5.9 months). Patients with immunohistochemistry-detectable tMBL had increased monoclonal B cells per total lymphocyte events, morphologic evidence of bone marrow involvement, higher white blood cell count, and increased absolute lymphocyte count.

The authors concluded that tMBL spans an immunophenotypic spectrum similar to MBL, is detectable by immunohistochemistry in a minority of cases (often CLL immunophenotype), and is likely systemic in most cases. Development of overt lymphoma is uncommon but may occur, warranting clinical follow-up. The study was published in the December 2021 issue of the journal Archives of Pathology and Laboratory Medicine.

Related Links:
Cleveland Clinic
BD Biosciences


New
Gold Supplier
Automated, Random Access Chemistry Analyzer
LIDA 300
New
Silver Supplier
Point-of-Care MDx System
STANDARD M10
New
Gold Supplier
Automatic Western Blot Analyzer
Tenfly Phoenix Blot Analyzer
New
Gold Supplier
Microplate-Strip Washer
Wellwash Versa

Print article

Channels

Molecular Diagnostics

view channel
Image: New chip could make treating metastatic cancer easier and faster (Photo courtesy of Georgia Institute of Technology)

Simple Blood Test Detection Method Could Revolutionize Cancer Treatment

Cancer spreads via circulating tumor cells (CTCs) that travel through the blood to other organs, and they are nearly impossible to track. When a tumor starts metastasizing, it sheds its cell into the blood.... Read more
Copyright © 2000-2022 Globetech Media. All rights reserved.