Polyclonal B-cell lymphocytosis: Report of three cases.

BACKGROUND: Persistent polyclonal B-cell lymphocytosis (PPBL) is a rare benign condition characterized by a polyclonal B-cell lymphocytosis with binucleated lymphocytes. We hereby report three cases of PPBL. METHODS: Flow cytometry immunophenotyping was performed in peripheral blood samples from three patients with clinical suspicion of lymphoproliferative disease. RESULTS: Case 1 was a female middle-aged smoker; Case 2 was an elderly male; and Case 3 was a non-smoker female. Flow cytometry evaluation of all cases revealed an expansion of mature B-cells, with a normal Kappa/Lambda light chain ratio; B-cell lymphocytes of Cases 2 and 3 had CD5 coexpression; Case 3 also had monocytosis. CONCLUSIONS: Diagnose of PPBL is important in order to avoid unnecessary diagnostic procedures and therapy. © 2018 International Clinical Cytometry Society.

Quantitative flow cytometric evaluation of CD200, CD123, CD43 and CD52 as a tool for the differential diagnosis of mature B-cell neoplasms

Abstract Background Distinction between mature B-cell neoplasms can be difficult due to overlapping of immunologic features and clinical manifestations. This study investigated whether quantifying mean fluorescence intensity of four monoclonal antibodies in a flow cytometry panel is useful for the differential diagnosis and characterization of these disorders. Methods The expressions of CD52, CD200, CD123 and CD43 were analyzed in samples from 124 patients with mature B-cell neoplasms. The quantitative estimation of these antigens was assessed by mean fluorescence intensity. Results The cases included were 78 chronic lymphocytic leukemias, three atypical chronic lymphocytic leukemias, six marginal zone lymphomas, 11 splenic marginal zone lymphomas, nine lymphoplasmacytic lymphomas, six mantle cell lymphomas, two hairy cell leukemias, two hairy cell leukemias variant, five follicular lymphomas, one Burkitt lymphoma and one diffuse large B-cell lymphoma. The mean fluorescence intensity of CD200 was higher in atypical chronic lymphocytic leukemia, chronic lymphocytic leukemia and hairy cell leukemia cases. CD123 showed higher mean fluorescence intensities in hairy cell leukemia cells. Chronic lymphocytic leukemia, atypical chronic lymphocytic leukemia and mantle cell lymphoma had higher expression of CD43 and all follicular lymphoma cases had very low mean fluorescence intensity values. CD52 expression was consistently positive among all cases. Conclusion Quantitative evaluation of these markers can be a useful additional tool to better identify some types of mature B-cell neoplasms.

Quantitative flow cytometric evaluation of CD200, CD123, CD43 and CD52 as a tool for the differential diagnosis of mature B-cell neoplasms.

BACKGROUND: Distinction between mature B-cell neoplasms can be difficult due to overlapping of immunologic features and clinical manifestations. This study investigated whether quantifying mean fluorescence intensity of four monoclonal antibodies in a flow cytometry panel is useful for the differential diagnosis and characterization of these disorders. METHODS: The expressions of CD52, CD200, CD123 and CD43 were analyzed in samples from 124 patients with mature B-cell neoplasms. The quantitative estimation of these antigens was assessed by mean fluorescence intensity. RESULTS: The cases included were 78 chronic lymphocytic leukemias, three atypical chronic lymphocytic leukemias, six marginal zone lymphomas, 11 splenic marginal zone lymphomas, nine lymphoplasmacytic lymphomas, six mantle cell lymphomas, two hairy cell leukemias, two hairy cell leukemias variant, five follicular lymphomas, one Burkitt lymphoma and one diffuse large B-cell lymphoma. The mean fluorescence intensity of CD200 was higher in atypical chronic lymphocytic leukemia, chronic lymphocytic leukemia and hairy cell leukemia cases. CD123 showed higher mean fluorescence intensities in hairy cell leukemia cells. Chronic lymphocytic leukemia, atypical chronic lymphocytic leukemia and mantle cell lymphoma had higher expression of CD43 and all follicular lymphoma cases had very low mean fluorescence intensity values. CD52 expression was consistently positive among all cases. CONCLUSION: Quantitative evaluation of these markers can be a useful additional tool to better identify some types of mature B-cell neoplasms.

Expression of Bruton's tyrosine kinase in B-cell neoplasms evaluated by flow cytometry.

Bruton's tyrosine kinase (BTK) is a cytoplasmatic protein that is part of the B-cell antigen receptor signaling pathway. Our aim was to evaluate the expression of BTK in B-cell neoplasms and compare it to normal B-cell lymphocytes. After surface staining with CD19 and CD45, flow cytometry staining for intracellular BTK was performed in leukemic or mature B-cells from bone marrow or peripheral blood samples. No differences in BTK expression were identified between groups, or in comparison to control samples, there was no association between BTK expression and the clinical variables evaluated. BTK expression in B-cell neoplasms was similar to that of normal B-cell lymphocytes.

Linfo-histiocitose hemofagocítica: tratamento com plasmaferese e gamaglobulina endovenosa / Haemophagocytic lymphohistiocitosis: treatment with plasmapheresis and intravenous immunoglobulin

O presente relato de caso tem como finalidade chamar a atenção de doença grave que frequentemente é confundida com septicemia, no entanto o mecanismo etiológico é decorrente de defeitos genéticos ou associados à resposta imunológica exagerada, decorrente de ação citotóxica de linfócitos T CD8 e histiócitos, acarretando proliferação clonal e ativação de células ”natural killer” (NK). Uma tempestade de linfocinas acontece e como consequência é iniciada uma incontrolável hemofagocitose de todos os elementos sanguíneos, terminando pela infecção secundária do organismo por ausência de destruição de patógenos. A maioria dos casos termina pela morte do paciente; no entanto, relatamos nesse caso a possibilidade de incluirmos a plasmaferese como forma de retirar as linfocinas circulantes, razão do estímulo à destruição celular. O tratamento concomitante com alta dose de imunoglobulina endovenosa também foi realizado

The purpose of the present case report is to call attention to a serious disease that is often mistaken with septicemia, although its etiological mechanism results from genetic defects or is associated with an immune over-reaction, resulting from cytotoxic action of CD8 T lymphocytes and histiocytes, causing clonal proliferation and activation of “natural killer” (NK) cells. There occurs a storm of lymphokines and, as a consequence, an uncontrollable hemophagocytosis of all blood elements, which leads to secondary infection of the organism because of absence of pathogens destruction. Although most of the cases end up in death, in this case we report the possibility of including plasmapheresis as a way to remove the circulating lymphokines, the reason for stimulation of cell destruction. Co-treatment with high dose of intravenous immunoglobulin was performed too

Manifestaçöes psiquiátricas da deficiência de vitamina B12 / Psychiatric manifestations of the B12 vitamin deficiency

Os autores revisam, neste artigo, os mecanismos fisiopatológicos, achados físicos e síndromes psiquiátricas ligados à hipovitaminose B12. Os quadros psiquiátricos podem aparecer antes ou após a anemia megaloblástica e mesmo desacompanhados desta. A carência de B12 foi mais relacionada, como fator causal, à depressäo, psicose e demência, tendo a deficiência de folato um papel na duraçäo dos episódios depressivos. Pelo menos em alguns pacientes com depressäo ou demência, ocorre a deterioraçäo do hábito alimentar, o que acaba levando ao déficit de cobaslamina, e näo o contrário. A mania e outros quadros, como comportamento violento, delírio, paranóia, alucinaçöes e mudança de comportamento, aparecem com menos frequência, mas devem ser lembrados como sintomas possíveis da carência de cobalamina

Manifestacoes psiquiatricas da deficiencia de vitamina B12

Os autores revisam, neste artigo, os mecanismos fisiopatologicos, achados fisicos e sindromes psiquiatricas ligados a hipovitaminose B12. Os quadros psiquiatricos podem aparecer antes ou apos a anemia megaloblastica e mesmo desacompanhados desta. A carencia de B12 foi mais relacionada, como fator causal, a depressao, psicose e demencia, tendo a deficiencia de folato um papel na duracao dos episodios depressivos. Pelo menos alguns pacientes com depressao ou demencia, ocorre a deterioracao do habito alimentar, o que acaba levando ao deficit de cobaslamina, e nao o contrario. A mania e outros quadros, como comportamento violento, delirio, paranoia, alucinacoes e mudanca de comportamento, aparecem com menos frequencia, mas devem ser lembrados como sintomas possiveis da carencia de cobalamina