B cell chronic lymphocytic leukemia with florid reactive CD4+ T cell lymphocytosis in lymph nodes.
This case is of an unusual florid reactive CD4+ T Cell lymphocytosis involving lymph node (LN) and overshadowing residual B chronic lymphocytic leukemia (CLL). A 65 year old female with a 9 year history of untreated B-CLL presented with weight loss, splenomegaly and lymphadenopathy. B-CLL was confirmed on the basis of peripheral blood lymphocytosis, bone marrow trephine findings and flow cytometry analysis. However, the LN biopsy showed appearances of a diffuse small lymphocytic population mimicking a leukemic T-cell infiltrate. Immunophenotyping and molecular analysis demonstrated the major cell population to be reactive CD4 positive T lymphocytes.
Busmanis
I
I
Department of Anatomical Pathology, Royal Melbourne Hospital, Victoria, Australia.
Hussein
S
S
Feleppa
F
F
Rockman
S
S
Begley
C G
CG
D000368:Aged; D014408:Biomarkers, Tumor; D001853:Bone Marrow / Q000473:pathology; D015496:CD4-Positive T-Lymphocytes; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D015321:Gene Rearrangement; D005803:Genes, Immunoglobulin; D006801:Humans; D006965:Hyperplasia; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007145:Immunoglobulin kappa-Chains / Q000235:genetics; D016130:Immunophenotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008218:Lymphocytosis / Q000209:etiology* / Q000473:pathology; D009333:Neck
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D007143:Immunoglobulin Heavy Chains; D007145:Immunoglobulin kappa-Chains