title: CD103+ γδ T cell large granular lymphocytosis in a patient with refractory celiac disease: a diagnostic enigma.
abstract: Indolent γδ T cell lymphomas/leukemias are rare and overlap with the morphological spectrum of large granular lymphocyte (LGL) leukemia. We report an extremely rare case of CD103(+) γδ T LGL leukemia in a patient with celiac disease who presented with refractory diarrhea. Whether the refractory diarrhea in our patient was a manifestation of LGL leukemia itself or whether the clonal LGL expansion is a manifestation of refractory celiac disease (RCD) remains an enigma. This report highlights the diagnostic difficulties and the need of consensus in categorizing clonal CD103(+) lymphocytosis in patients with RCD.
authors: Department of Hematology, Post Graduate Institute of Medical Education and Research (PGIMER), V Floor, SS Anand Block (Research Block A), Chandigarh, 160012, India, dr.s.sreejesh@gmail.com.
authors: Sreejesh
authors: S
authors: Sreedharanunni
authors: Neelam
authors: N
authors: Varma
authors: Man Updesh Singh
authors: MU
authors: Sachdeva
authors: Kirti
authors: K
authors: Gupta
authors: Rekha
authors: R
authors: Pai
authors: Rakesh
authors: R
authors: Kochhar
authors: Pankaj
authors: P
authors: Malhotra
authors: Subhash
authors: S
authors: Varma
mesh_terms: D015703:Antigens, CD / Q000032:analysis*; D002446:Celiac Disease / Q000150:complications*; D003967:Diarrhea / Q000150:complications; D006801:Humans; D016130:Immunophenotyping; D039001:Integrin alpha Chains / Q000032:analysis*; D054066:Leukemia, Large Granular Lymphocytic / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000473:pathology*
chemical_list: D015703:Antigens, CD; D039001:Integrin alpha Chains; C091367:alpha E integrins
references: J Exp Med. 2005 Oct 17;202(8):1051-61
references: 16216886
references: J Exp Med. 2007 Mar 19;204(3):559-70
references: 17325197
references: Br J Haematol. 2011 May;153(4):451-85
references: 21480860
references: Leuk Lymphoma. 2000 Sep;39(1-2):97-111
references: 10975388
references: Arch Pathol Lab Med. 2008 Nov;132(11):1774-80
references: 18976014
references: Eur J Immunol. 1987 Sep;17(9):1279-85
references: 3498635
references: Gastroenterology. 2012 Dec;143(6):1470-1472.e2
references: 22922421
references: Am J Clin Pathol. 2011 Oct;136(4):625-30
references: 21917686
references: Gut. 2010 Apr;59(4):547-57
references: 20332526
references: Blood. 1998 Nov 15;92(10):3879-86
references: 9808581
references: J Immunol. 2006 Sep 1;177(5):2775-83
references: 16920912
references: Rev Med Interne. 1997;18(3):237-9
references: 9161577
references: Am J Surg Pathol. 2011 Aug;35(8):1214-25
references: 21753698
references: Leuk Res. 2008 Jan;32(1):45-8
references: 17544120
references: Gastroenterology. 2009 Jan;136(1):81-90
references: 19014942
references: Semin Hematol. 2003 Jul;40(3):233-43
references: 12876672
references: Am J Hematol. 1993 Jun;43(2):116-22
references: 8342538
references: Cytometry B Clin Cytom. 2005 Sep;67(1):6-12
references: 15973700