Increased incidence of monoclonal B-cell infiltrate in chronic myeloproliferative disorders

Abstract

A total of 106 trephine biopsy specimens with clinical, laboratory and pathology findings corresponding to chronic myeloproliferative disorders (CMPD) were analyzed to reveal the nature of the lymphoid infiltrate in the bone marrow. Histological investigation in 31 chronic myeloid leukemia (CML), 29 CMPDs not otherwise specified (CMPD-NOS), 28 essential thrombocytosis (ET), 15 polycythemia vera (PV) and three chronic eosinophilic leukemia/hypereosinophilic syndrome (CEL/HES) exhibited in 32% various amounts of lymphocytic infiltrate of sparsely to moderately diffuse or nodular types in the bone marrow, but the reactive or coinciding lymphomatous nature could not be revealed by histology alone in the majority of cases. PCR analysis of the immunoglobulin heavy chain (IgH) gene rearrangement was successfully performed in 81 out of the 106 DNA specimens extracted from formol-paraffin blocks. Out of the 81 samples with good-quality DNA, 18 gave a single or double discrete amplification band(s), which was reproducible only in four specimens. Sequencing finally proved monoclonal B-cell population of both pre-and postfollicular origin in all four samples (5%), one CML and three CMPD-NOS. Detailed clinical and pathological investigations indicated overt B-cell malignant lymphoma with clonal relationship to the CMPD in two out of these four patients. We conclude that detailed molecular analysis of IgH gene rearrangement in bone marrow samples of CMPD patients is needed to identify the true monoclonal B-cell infiltration, which-even without overt malignant lymphoma-may occur in this group of disorders.

Lymphoma of the Female Genital Tract: Current Status

“…Recently, monoclonal B cells (49) have been shown in these ''reactive'' lesions. There are several other instances in which clonal lymphoid populations were detected in reactive conditions (106)(107)(108)(109)(110)(111)(112)(113). Whereas some monoclonal bands obtained by polymerase chain reaction-based techniques may be spurious, as in those cases with low number of B cells (114), in other reactive cases, true monoclonal B or T cells are present.…”

B Cells and Antibodies in Kawasaki Disease

“…In KD it is proposed that these plasma cells mature in situ from initial B cell infiltration. Monoclonal B cell infiltrates have been shown in other disorders [90]. Additionally, in situ lymphoid neogenesis is described in numerous inflammatory and infectious disease systems [91,92,93,94] and some oncologic processes [95,96].…”

Absence of the V617F JAK2 Mutation in the Lymphoid Compartment in a Patient with Essential Thrombo- cythemia and B-Chronic Lymphocytic Leukemia and in Two Relatives with Lymphoproliferative Disorders

“…According to the literature, only a few cases have been reported [3,4,5,6], although indolent B-cell malignant lymphomas of various types may coexist with chronic myeloproliferative disorders, and various amounts of lymphocytic infiltrate are a well-known feature of different CMPDs [7,8]. Moreover, clonal B-cell population (5%) or overt B-cell malignant lymphoma (2.5%) is more frequent in CMPDs than would be expected from the 5.4–8.1 per 100,000 population incidence rate of non-Hodgkin’s lymphomas in Europe; this implies a kind of predisposition for the development of monoclonal B-cell population in CMPD patients [9]. …”