Perforin-positive leukemic cell infiltration in the heart of a patient with T-cell prolymphocytic leukemia.
Here we report a rare case of T-cell prolymphocytic leukemia in whom leukemic killer cells, expressing a cytolytic factor perforin, infiltrated the heart. Perforin may have directly injured myocardial cells which showed marked expression of human leukocyte antigens (HLAs) and intercellular adhesion molecule-1 (ICAM-1) as well as costimulatory molecules B7 and B70, which are ligands for CD28 expressed on T-cells. In spite of chemotherapy against leukemic cells, this autoimmune process finally caused fatal congestive heart failure.
Seko
Y
Y
Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo.
Azuma
M
M
Yagita
H
H
Okumura
K
K
Hirai
H
H
Nagai
R
R
Yazaki
Y
Y
D000328:Adult; D017809:Fatal Outcome; D006333:Heart Failure / Q000209:etiology* / Q000473:pathology; D006801:Humans; D015463:Leukemia, Prolymphocytic / Q000473:pathology*; D017254:Leukemic Infiltration; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis*; D009206:Myocardium / Q000473:pathology*; D054353:Perforin; D052899:Pore Forming Cytotoxic Proteins
D008562:Membrane Glycoproteins; D052899:Pore Forming Cytotoxic Proteins; D054353:Perforin