Small clonal B-cell population in the bone marrow as a possible tool in the diagnosis of occult primary parotid lymphoma
Main Article Content
Case Description:
An 82-years old Hispanic woman with a past medical history significant for pulmonary thromboembolism on oral anticoagulation, rheumatoid arthritis, and hypertension developed a new onset thrombocytopenia.
Small clonal B-cells populations (SCBP) also known as monoclonal B-cell lymphocytosis was found as part of the workup for an idiopathic thrombocytopenia and lead ultimately to the diagnosis of parotid primary follicular lymphoma coexisting with Warthin tumor involving the bone marrow in a small extent and oncocytic papilloma located in the maxillary sinus.
Patient was treated with Rituximab monotherapy with improvement on her platelet count.
Although it is unclear the role of this clonal cells, they may work as a possible diagnostic tool for occult lymphomas. Further prospective studies are needed to confirm this possible association.
. Nieto WG, Teodosio C, Lopez A, Rodriguez-Caballero A, Romero A, Barcena P, et al . Non-CLL-like monoclonal B-cell lymphocytosis in the general population: prevalence and phenotypic/genetic characteristics. Cytometry B Clin Cytom. 2010;78(Suppl 1):S24–S34.
Marti GE, Rawstron AC, Ghia P, Hillmen P, Houlston RS, Kay N, et al . Diagnostic criteria for monoclonal B-cell lymphocytosis. Br J Haematol. 2005;130(3):325–332.
Wang C, Amato D, Fernandes B. CD5-negative phenotype of monoclonal B-lymphocytosis of undetermined significance (MLUS) Am J Hematol. 2002;69(2):147–149.
Vardi A, Dagklis A, Scarfo L, Jelinek D, Newton D, Bennett F, et al . Immunogenetics shows that not all MBL are equal: the larger the clone the more similar to CLL. Blood. 2013;17:4521–4528.
Shim YK, Vogt RF, Middleton D, Abbasi F, Slade B, Lee KY, et al . Prevalence and natural history of monoclonal and polyclonal B-cell lymphocytosis in a residential adult population. Cytometry B Clin Cytom. 2007;72(5):344–353.
Rawstron AC, Shanafelt T, Lanasa MC, Landgren O, Hanson C, Orfao A, et al . Different biology and clinical outcome according to the absolute numbers of clonal B-cells in monoclonal B-cell lymphocytosis (MBL) Cytometry B Clin Cytom. 2010;78(1):S19–S23.
Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al . Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579–586.
Neunert C, Lim W, Crowther M, Cohen A, Solberg L, Jr, Crowther MA, et al . The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood.2011;117(16):4190–4207.
Casabonne D, Almeida J, Nieto WG, Romero A, Fernandez-Navarro P, Rodriguez-Caballero A, et al . Common infectious agents and monoclonal B-cell lymphocytosis: a cross-sectional epidemiological study among healthy adults. PloS One. 2012;7(12):
Fazi C, Scarfo L, Pecciarini L, Cottini F, Dagklis A, Janus A, et al . General population low-count CLL-like MBL persists over time without clinical progression, although carrying the same cytogenetic abnormalities of CLL. Blood. 2011;118(25):6618–6625.
Chen W, Asplund SL, McKenna RW, Kroft SH. Characterization of incidentally identified minute clonal B-lymphocyte populations in peripheral blood and bone marrow. Am J Clinical Pathol.2004;122(4):588–595.
Downloads
Accepted 2015-12-11
Published 2016-02-19
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use