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In the massively enlarged spleen, extramedullary hemopoiesis was prominent, with clusters of atypical megakaryocytes with vacuoles and erythrophagocytosis.
These sites all contain a primitive, self-renewing population of blood-cell precursors, the haemopoietic stem cells, which are capable of producing all the different cells of the blood.
One may speculate that these immature B cells may play a critical role in the regenerative regulation of hemopoiesis , as well as in immune functions in the context of chronic cytopenias.
Acquisition of genomic aberrations, a hallmark of malignancy, in regions of the genome that contain hemopoietic cell regulatory genes may also contribute to lymphomagenesis.
The patients in our study demonstrated a PCP-associated decrease in total blood lymphocyte counts, suggesting that long-term exposure to PCP inhibits compensatory hemopoietic activity.
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