Laboratory findings in CD4(+) large granular lymphocytoses.
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 Tgamma PCR positive. Our results support that CD4(+) T-LGL lymphocytosis is a clonal disorder with clinicopathologic characteristics distinct from the more common CD8(+) variant.
Olteanu
H
H
Department of Pathology, Medical College of Wisconsin, Milwaukee, WI 53226, USA. holteanu@mcw.edu
Karandikar
N J
NJ
Eshoa
C
C
Kroft
S H
SH
D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D019002:CD56 Antigen / Q000276:immunology; D018959:CD57 Antigens / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D054066:Leukemia, Large Granular Lymphocytic / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D019002:CD56 Antigen; D018959:CD57 Antigens