Transient monoclonal expansion of CD8+/CD57+ T-cell large granular lymphocytes after primary cytomegalovirus infection.
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.
Rossi
Davide
D
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
Franceschetti
Silvia
S
Capello
Daniela
D
De Paoli
Lorenzo
L
Lunghi
Monia
M
Conconi
Annarita
A
Gaidano
Gianluca
G
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*
D015703:Antigens, CD; D018959:CD57 Antigens; D016827:CD8 Antigens