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  1. Home /
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  3. Vol 47 No 1 (2016) /
  4. Case Report

Small clonal B-cell population in the bone marrow as a possible tool in the diagnosis of occult primary parotid lymphoma

  • Abstract
  • Keywords
  • Author Biographies
  • References

Abstract

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.

Clinical Findings:

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.

Treatment and Outcome:

Patient was treated with Rituximab monotherapy with improvement on her platelet count.

Clinical relevance:

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.

Authors

  • Martha Romero Department of Pathology. Fundación Santa Fe de Bogotá, Bogotá, Colombia
  • Guido R. González-Fontal Division of Hemato-Oncology. Clínica Rey David, Cali, Colombia
  • Mónica Duarte Hematology. Fundación Santa Fe de Bogotá, Bogotá, Colombia
  • Carlos Saavedra Department of Pathology. Fundación Santa Fe de Bogotá, Bogotá, Colombia
  • Andrés F. Henao-Martínez University of Colorado Denver

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Keywords

  • B-lymphocytes
  • bone marrow
  • diagnosis
  • lymphoma
  • parotid gland

Author Biographies


, Department of Pathology. Fundación Santa Fe de Bogotá, Bogotá, Colombia
Department of Pathology. Fundación Santa Fe de Bogotá, Bogotá, Colombia

, Division of Hemato-Oncology. Clínica Rey David, Cali, Colombia
Division of Hemato-Oncology. Clínica Rey David, Cali, Colombia

, Hematology. Fundación Santa Fe de Bogotá, Bogotá, Colombia
Hematology. Fundación Santa Fe de Bogotá, Bogotá, Colombia

, Department of Pathology. Fundación Santa Fe de Bogotá, Bogotá, Colombia
Department of Pathology. Fundación Santa Fe de Bogotá, Bogotá, Colombia

, University of Colorado Denver

Department of Medicine

Division of Infectious Diseases

References

. 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.

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Published
2016-02-19
Submitted
2014-12-18
| 798 |
How to Cite
Romero, M., González-Fontal, G., Duarte, M., Saavedra, C., & Henao-Martínez, A. (2016). Small clonal B-cell population in the bone marrow as a possible tool in the diagnosis of occult primary parotid lymphoma. Colombia Médica, 47(1), 59-62. https://doi.org/10.25100/cm.v47i1.1842
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Vol 47 No 1 (2016)
Section
Case Report

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