Persistent polyclonal B lymphocytosis: an expansion of cells showing IgVH gene mutations and phenotypic features of normal lymphocytes from the CD27⁺ marginal zone B‐cell compartment

Abstract

Persistent polyclonal B-cell lymphocytosis (PPBL) is an unusual and benign lymphoproliferation characterized by a polyclonal expansion of B lymphocytes, whose nature remains undetermined. The phenotypic analysis of three cases revealed that these cells were CD27+ IgM(high) CD21(high) CD5(low) and CD23(low), a phenotype associated with the normal marginal zone (MZ) B-cell compartment. As MZ B cells have initiated immunoglobulin (Ig)V gene somatic mutations, PPBL IgVH genes were sequenced. An average of 73% of these sequences were mutated. The mean number of mutation per sequence was 6.9, a number similar to those observed in the MZ B-cell compartment.