title: A case of CD4(+)T-cell large granular lymphocytic leukemia.
abstract: We report here a case of a 59-yr-old man with CD4(+) T-cell large granular lymphocytic leukemia (T-LGL). Peripheral blood examination indicated leukocytosis (45×10(9) cells/L) that consisted of 34% neoplastic lymphoid cells. Other laboratory results indicated no specific abnormalities except for serum antinuclear antibody titer (1:640), glucose (1.39 g/L), and hemoglobin A1c (7.7%) levels. Computed tomography indicated multiple small enlarged lymph nodes (<1 cm in diameter) in both the axillary and inguinal areas, a cutaneous nodule (1.5 cm in diameter) in the left suboccipital area, and mild hepatosplenomegaly. Bone marrow examination revealed hypercellular marrow that consisted of 2.4% neoplastic lymphoid cells. The neoplastic lymphoid cells exhibited a medium size, irregularly shaped nuclei, a moderate amount of cytoplasm, and large granules in the cytoplasm. Immunohistochemical analysis indicated CD3(+), CD4(+), T-cell receptor βF1(+), granzyme B(+), and TIA1(+). Flow cytometric analysis of the neoplastic lymphoid cells revealed CD3+, cytoplasmic CD3(+), CD4(+), and CD7(+). Cytogenetic analysis indicated an abnormal karyotype of 46,XY,inv(3)(p21q27),t(12;17)(q24.1;q21),del(13)(q14q22)[2]/46,XY[28]. The patient was diagnosed with CD4(+) T-LGL and received chemotherapy (10.0 mg methotrexate). This is the second case of CD4(+) T-LGL that has been reported in Korea.
authors.affiliation: Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jaewook
authors.initials: J
authors.lastname: Kim
authors.forename: Chan Jeoung
authors.initials: CJ
authors.lastname: Park
authors.forename: Seongsoo
authors.initials: S
authors.lastname: Jang
authors.forename: Young-Uk
authors.initials: YU
authors.lastname: Cho
authors.forename: Sang Hyuk
authors.initials: SH
authors.lastname: Park
authors.forename: Eul-Ju
authors.initials: EJ
authors.lastname: Seo
authors.forename: Hyun-Sook
authors.initials: HS
authors.lastname: Chi
authors.forename: Cheolwon
authors.initials: C
authors.lastname: Suh
mesh_terms: D000974:Antibodies, Antinuclear / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D001854:Bone Marrow Cells / Q000378:metabolism / Q000473:pathology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D007621:Karyotyping; D054066:Leukemia, Large Granular Lymphocytic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D000974:Antibodies, Antinuclear; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: CD4+ T-LGL skin lesion; Leukocytosis