Hematopathologic features of T-cell large granular lymphocytic leukemia.
- VernacularTitle:T大颗粒淋巴细胞白血病的血液病理学特点
- Author:
En-bin LIU
1
;
Hui-shu CHEN
;
Pei-hong ZHANG
;
Zhan-qi LI
;
Qi SUN
;
Qing-ying YANG
;
Li-huan FANG
;
Fu-jun SUN
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Anemia; metabolism; pathology; Bone Marrow; pathology; CD3 Complex; metabolism; CD57 Antigens; metabolism; CD8 Antigens; metabolism; Diagnosis, Differential; Female; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; Granzymes; metabolism; Humans; Immunophenotyping; Leukemia, Large Granular Lymphocytic; metabolism; pathology; Lymphocytosis; metabolism; pathology; Male; Middle Aged; Neutropenia; metabolism; pathology; Poly(A)-Binding Proteins; metabolism; Retrospective Studies; T-Cell Intracellular Antigen-1
- From: Chinese Journal of Pathology 2012;41(4):229-233
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo explore the hematopathologic features of T-cell large granular lymphocytic leukemia (T-LGLL).
METHODSA retrospective analysis of the clinical presentation, bone marrow morphology, immunophenotyping and T-cell receptor gene rearrangement status were performed in 19 patients with T-LGLL.
RESULTSOf 19 patients, the most frequent hematological abnormalities were anemia and neutropenia (16/19 and 17/19 patients, respectively). Large granular lymphocytes (LGLs) were observed in 17 of 19 peripheral blood smears and 15 of 19 bone marrow aspirate specimens. Lymphocytosis (> 0.2) was present in 17 of 19 patients in their bone marrow aspirate specimens. Bone marrow biopsy specimens revealed lymphocytosis in 16 cases, with a mild to moderate increase of lymphocytes observed in 12 cases (12/16). The pattern of lymphoid distribution was interstitial in bone marrow sections. Intravascular distribution was seen in 8 cases. Lymphoid nodules were present in 4 cases. Flow cytometery showed an immunophenotype of CD3(+) CD4(-) CD8(+) CD56(-) CD57(+) of the tumor cells in 13 cases. Of the other 6 cases, the immunophenotypes included CD8(-) (1 case), CD56(+) (2 cases) and CD57(-) (3 cases). Immunohistochemistry showed CD3+ (10/10), CD57+ (3/3), CD8+ (6/7), TIA-1+ (6/7), granzyme B+ (4/7), perforin + (1/7), CD4- (4/4) and CD56- (9/9). Clonal T-cell receptor γ gene rearrangement by PCR was detected in 12 cases (12/17).
CONCLUSIONSHematopathologic features of most T-LGLL are distinct. Morphologic, immunophenotypic and molecular analysis of both peripheral blood and bone marrow specimens are essential and complementary in the diagnosis and differential diagnosis of T-LGLL.
