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Laboratory findings in CD4(+) large granular lymphocytoses
Author(s) -
OLTEANU H.,
KARANDIKAR N. J.,
ESHOA C.,
KROFT S. H.
Publication year - 2010
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/j.1751-553x.2008.01109.x
Subject(s) - lymphocytosis , hepatosplenomegaly , cd8 , malignancy , cytotoxic t cell , immunophenotyping , cd3 , pathology , immunology , medicine , biology , antigen , biochemistry , disease , in vitro
Summary Large granular lymphocytic (LGL) leukemia is an uncommon disorder of mature T or natural killer (NK) cells. Most T‐LGL proliferations are CD3(+)/CD8(+), although rare CD4(+) clonal T‐LGL expansions have been reported. We report the clinicopathologic features of eight patients with aberrant CD4(+), cytotoxic T‐cell lymphocytoses. Median follow‐up was 29 months (range 8–100), during which all were alive without requirement for therapy. Four of eight patients had an additional malignancy; none had a history of rheumatoid arthritis, lymphadenopathy or hepatosplenomegaly. Morphologic expansions of granulated lymphocytes were evident in 6/8. All had immunophenotypically aberrant populations of CD4(+) T cells with uniform, moderate or bright CD56. Seven of eight expressed CD57, and four were CD8(partial dim +). Abnormal levels of expression of two or more T‐cell antigens were seen in all cases. All tested cases were Tγ PCR positive. Our results support that CD4(+) T‐LGL lymphocytosis is a clonal disorder with clinicopathologic characteristics distinct from the more common CD8(+) variant.