Hi Everyone,

This is a question for the Hematology experts out there.  What is the clinical significance of someone that has chronic reactive absolute lymphocytosis with a normal WBC count? Do you think more testing to follow-up is required and if so what test(s)? I've done lots of research on this topic, but wanted to see what everyone's thoughts/ideas are regarding this topic.

I'm not an expert, but flow cytometry may be helpful to classify the lymphocytes (B-cell, T-cell, NK cells) and see if an abnormal immunophenotype exists.

I agree that it is possible that the "reactive" lymphs may be lymphoma cells.  If the patient is middle-aged or older it could also be an early CLL.  They should probably see a hematologist.

Scott

Yea, I was thinking flow cyto would be a good start to see if it's not something more serious.  They don't look like lymphoma cells at all - they look like the typical reactive lymphocytes you would see on a peripheral smear.

Hi

Autoimmune disorders and chronic viral infections can also be the possibilities

Saima

Edited December 14, 20177 yr by mminhas44

If these cells are Lymphoma cells, and if I am not mistaken, would a follow-up Urine Electrophoreses be in order to detect Bence/Jones proteins?

I would say you are thinking of multiple myeloma.  The urine B-J test is a screen.  Urine kappa/lambda and electropherisis would be more conclusive, but then one would be seeing plamacytoid lymphs if anything.

Scott

23 hours ago, SMILLER said:

I would say you are thinking of multiple myeloma.  The urine B-J test is a screen.  Urine kappa/lambda and electropherisis would be more conclusive, but then one would be seeing plamacytoid lymphs if anything.

Scott

Thank you Scott. Multiple Myeloma is what I was thinking of.