PMC4944328_01
Peripheral blood smear shows large granular lymphocyte (a) [100x, May-Grunwald-Giemsa (MGG) stain]; Bone marrow aspirate shows erythroblastopenia and large granular lymphocytes (b) (100x, MGG stain); trephine biopsy shows reactive lymphoid nodules (c) (20x, H&E stain) composed of CD20+ cells (d) (20x) and CD3+ cells (e) (20x); CD8+ cells in the interstitium (f) (20x)
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F1
Peripheral blood (PB) smear showed absolute lymphocytosis (6993/mul) with >90% of them being LGLs [Figure 1a]. BM trephine biopsy showed multiple reactive lymphoid nodules composed of both B cells and T cells, as revealed by immunohistochemistry [Figure 1b-f].
Clinical course of the patient. (MMF - mycophenolate mofetil; CsA - cyclosporine)
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F2
The subsequent clinical course is summarized in Figure 2.
Flow cytometry performed on peripheral blood. CD3+ cells (92% of lymphocytes) were gated. 48% of T cells were gammadelta TCR+ (3a), which were CD2+CD7+ (not shown), CD8+ (variable) (3a), CD5- (3b), CD4- (3c), CD57+(variable), CD56- (3d), and CD16+ (not shown)
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F3