PPBL - Slide 1

Troussard (2008)

This specimen shows a "persistent polyclonal b-cell lymphocytosis" (PPBL), a benign condition recognizable by abnormal lymphocytes with a bilobular nucleus.

This syndrome is often seen in middle-aged women who smoke a lot. Other features include a prolonged increased number of lymphocytes that are polyclonal in nature (normal kappa/lambda ratio). Increased IgM is also often found. Clinically, patients usually present with symptoms such as fatigue or chronic pain. The mechanism behind PPBL is unknown, but the abnormal lymphocytes often disappear when patients stop smoking.

This patient smoked 15 cigarettes a day and had an elevated lymphocyte count for many years. An elevated IgM of

3.15 g/L

was also found.

XN Scatterplots

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