A Case of CD4+T-Cell Large Granular Lymphocytic Leukemia.
10.3343/alm.2013.33.3.196
- Author:
Jaewook KIM
1
;
Chan Jeoung PARK
;
Seongsoo JANG
;
Young Uk CHO
;
Sang Hyuk PARK
;
Eul Ju SEO
;
Hyun Sook CHI
;
Cheolwon SUH
Author Information
1. Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. cjpark@amc.seoul.kr
- Publication Type:Case Reports
- Keywords:
CD4+ T-LGL skin lesion;
Leukocytosis
- MeSH:
Antibodies, Antinuclear/analysis;
Blood Glucose/analysis;
Bone Marrow Cells/metabolism/pathology;
Hemoglobin A, Glycosylated/metabolism;
Humans;
Immunohistochemistry;
Immunophenotyping;
Karyotyping;
Leukemia, Large Granular Lymphocytic/*diagnosis/pathology/radiography;
Lymph Nodes/pathology;
Male;
Middle Aged;
Neoplastic Cells, Circulating/metabolism/pathology;
Tomography, X-Ray Computed
- From:Annals of Laboratory Medicine
2013;33(3):196-199
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report here a case of a 59-yr-old man with CD4+ T-cell large granular lymphocytic leukemia (T-LGL). Peripheral blood examination indicated leukocytosis (45x10(9) cells/L) that consisted of 34% neoplastic lymphoid cells. Other laboratory results indicated no specific abnormalities except for serum antinuclear antibody titer (1:640), glucose (1.39 g/L), and hemoglobin A1c (7.7%) levels. Computed tomography indicated multiple small enlarged lymph nodes (<1 cm in diameter) in both the axillary and inguinal areas, a cutaneous nodule (1.5 cm in diameter) in the left suboccipital area, and mild hepatosplenomegaly. Bone marrow examination revealed hypercellular marrow that consisted of 2.4% neoplastic lymphoid cells. The neoplastic lymphoid cells exhibited a medium size, irregularly shaped nuclei, a moderate amount of cytoplasm, and large granules in the cytoplasm. Immunohistochemical analysis indicated CD3+, CD4+, T-cell receptor betaF1+, granzyme B+, and TIA1+. Flow cytometric analysis of the neoplastic lymphoid cells revealed CD3+, cytoplasmic CD3+, CD4+, and CD7+. Cytogenetic analysis indicated an abnormal karyotype of 46,XY,inv(3)(p21q27),t(12;17)(q24.1;q21),del(13)(q14q22)[2]/46,XY[28]. The patient was diagnosed with CD4+ T-LGL and received chemotherapy (10.0 mg methotrexate). This is the second case of CD4+ T-LGL that has been reported in Korea.
