title: A case of CD10-negative angioimmunoblastic T cell lymphoma with leukemic change and increased plasma cells mimicking plasma cell leukemia: A case report.
abstract: Angioimmunoblastic T cell lymphoma (AITL) is a peripheral T cell lymphoma, known to express CD3 and CD4, and, frequently, also CD10 and c-Maf-1. Hypergammaglobulinemia is not particularly rare in patients with AITL. However, AITL in conjunction with plasmacytosis in the peripheral blood is rare. The current report presents a case of CD10-negative AITL demonstrating leukemic change and plasmacytosis in the peripheral blood mimicking plasma cell leukemia. A 78-year-old male was admitted to hospital due to systemic lymph node enlargement, high serum IgG and IgA, and increased counts of plasmacytoid cells and lymphoid cells with atypical nuclei in the peripheral blood. Initially, plasma cell leukemia was suspected, due to the extreme increase in the number of plasma cells in the peripheral blood. However, the plasma cells did not show clonal expansion on examination by flow cytometry. Based on histological analyses, following a biopsy of an enlarged lymph node, the patient was diagnosed with AITL. This case suggests that when hypergammaglobulinemia and increases in B-lineage cells are observed, AITL should be considered in addition to disorders of B-lineage cells.
authors.affiliation: Division of Surgical Pathology, Toyooka Hospital, Toyooka City, Hyogo 668-8501, Japan ; Department of Stem Cell Disorders, Kansai Medical University, Hirakata City, Osaka 573-1010, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Adachi
authors.affiliation: Department of Internal General Medicine, Toyooka Hospital, Toyooka City, Hyogo 668-8501, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Hino
authors.affiliation: Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka City, Osaka 545-0051, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohsawa
authors.affiliation: Department of Internal General Medicine, Toyooka Hospital, Toyooka City, Hyogo 668-8501, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Ueki
authors.affiliation: Department of Clinical Laboratory, Toyooka Hospital, Toyooka City, Hyogo 668-8501, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Murao
authors.affiliation: Department of Stem Cell Disorders, Kansai Medical University, Hirakata City, Osaka 573-1010, Japan.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Stem Cell Disorders, Kansai Medical University, Hirakata City, Osaka 573-1010, Japan ; Japan Immunoresearch Laboratories Co. Ltd., Takasaki City, Gunma 370-0021, Japan.
authors.forename: Yunze
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Internal Medicine, Otokoyama Hospital, Yawata City, Kyoto 614-8366, Japan.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Okigaki
authors.affiliation: Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe City, Hyogo 650-0017, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Stem Cell Disorders, Kansai Medical University, Hirakata City, Osaka 573-1010, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Ikehara
keywords: angioimmunoblastic T cell lymphoma; bone marrow; hypergammaglobulinemia; leukemic change; lymph node; peripheral blood; plasmacytosis