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Rapidly fatal leukemia comprising pleomorphic large granular lymphocytes: a report of 2 cases.

Journal Article


Abstract


  • Background

    Large granular lymphocytes (LGLs) are either cytotoxic T or natural killer (NK) cells exhibiting round nuclei and azurophilic cytoplasmic granules. Morphologically, neoplastic LGLs of T cell lineage (T-LGLLs) are usually indistinguishable from normal LGLs, while there is a wide morphological range of aggressive NK cell leukemia (ANKL).

    Cases

    We present 2 consecutive cases of leukemia comprising pleomorphic LGLs. One patient presented with drowsy consciousness and unstable hemodynamics. Her peripheral blood smear disclosed a significant number of LGLs with pleomorphic nuclei expressing CD2, CD56 and HLA-DR but not surface or cytoplasmic CD3 (cCD3). The second patient, previously healthy, presented with a sudden death. Her peripheral blood revealed LGLs ranging from round to pleomorphic nuclei with a CD2+ cCD3+ surface CD3- CD56+ phenotype and clonally rearranged T cell receptor gene. The findings of the first patient were consistent with ANKL and the second, T-LGLL. Both patients passed away shortly before treatment.

    Conclusion

    The 2 cases highlight the importance of a multidisciplinary approach in addition to cytological examination to reach accurate diagnoses of such rare leukemia cases.

Publication Date


  • 2013

Citation


  • Win, K. T., Hsieh, Y. -C., Yang, C. -C., Chang, S. -T., Su, Y. -Z., Tien, H. -F., & Chuang, S. -S. (2013). Rapidly fatal leukemia comprising pleomorphic large granular lymphocytes: a report of 2 cases.. Analytical and quantitative cytopathology and histopathology, 35(4), 232-236.

Web Of Science Accession Number


Start Page


  • 232

End Page


  • 236

Volume


  • 35

Issue


  • 4

Place Of Publication


Abstract


  • Background

    Large granular lymphocytes (LGLs) are either cytotoxic T or natural killer (NK) cells exhibiting round nuclei and azurophilic cytoplasmic granules. Morphologically, neoplastic LGLs of T cell lineage (T-LGLLs) are usually indistinguishable from normal LGLs, while there is a wide morphological range of aggressive NK cell leukemia (ANKL).

    Cases

    We present 2 consecutive cases of leukemia comprising pleomorphic LGLs. One patient presented with drowsy consciousness and unstable hemodynamics. Her peripheral blood smear disclosed a significant number of LGLs with pleomorphic nuclei expressing CD2, CD56 and HLA-DR but not surface or cytoplasmic CD3 (cCD3). The second patient, previously healthy, presented with a sudden death. Her peripheral blood revealed LGLs ranging from round to pleomorphic nuclei with a CD2+ cCD3+ surface CD3- CD56+ phenotype and clonally rearranged T cell receptor gene. The findings of the first patient were consistent with ANKL and the second, T-LGLL. Both patients passed away shortly before treatment.

    Conclusion

    The 2 cases highlight the importance of a multidisciplinary approach in addition to cytological examination to reach accurate diagnoses of such rare leukemia cases.

Publication Date


  • 2013

Citation


  • Win, K. T., Hsieh, Y. -C., Yang, C. -C., Chang, S. -T., Su, Y. -Z., Tien, H. -F., & Chuang, S. -S. (2013). Rapidly fatal leukemia comprising pleomorphic large granular lymphocytes: a report of 2 cases.. Analytical and quantitative cytopathology and histopathology, 35(4), 232-236.

Web Of Science Accession Number


Start Page


  • 232

End Page


  • 236

Volume


  • 35

Issue


  • 4

Place Of Publication