title: Transient monoclonal expansion of CD8+/CD57+ T-cell large granular lymphocytes after primary cytomegalovirus infection.
abstract: Lymphocytosis associated with viral infection is generally polyclonal or oligoclonal. In this article, we describe a case of transient monoclonal CD8+/CD57+ T-cell lymphocytosis with large granular lymphocyte (LGL) morphology occurring after primary CMV infection and review cases of virus-associated monoclonal CD8+ T-cell expansions reported in the literature. Several clinical features shared by virus-associated monoclonal CD8+ T-cell expansions suggest the reactive nature of the lymphocytosis. Based on this, our case report and those reported in the literature support the notion that T-cell receptor clonality per se is not necessarily indicative of malignancy. These observations further corroborate the need for a close follow-up before assigning the diagnosis of LGL leukemia to individuals developing monoclonal CD8+ T-cell expansions.
authors.affiliation: Division of Hematology, Department of Clinical and Experimental Medicine and IRCAD, Amedeo Avogadro University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy. rossidav@med.unipmn.it
authors.forename: Davide
authors.initials: D
authors.lastname: Rossi
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschetti
authors.forename: Daniela
authors.initials: D
authors.lastname: Capello
authors.forename: Lorenzo
authors.initials: L
authors.lastname: De Paoli
authors.forename: Monia
authors.initials: M
authors.lastname: Lunghi
authors.forename: Annarita
authors.initials: A
authors.lastname: Conconi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gaidano
mesh_terms: D015703:Antigens, CD / Q000276:immunology; D018959:CD57 Antigens / Q000276:immunology*; D016827:CD8 Antigens / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000235:genetics / Q000276:immunology*; D042622:DNA Repeat Expansion; D006801:Humans; D008213:Lymphocyte Activation; D008218:Lymphocytosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D015703:Antigens, CD; D018959:CD57 Antigens; D016827:CD8 Antigens