Clinical Question
Maryalice Stetler-Stevenson (stetler@box-s.nih.gov)
Mon, 26 Feb 1996 16:34:24 -0400
Clinical Flow People- Especially those with extensive experience in bizarre
reactive T-cells.
Background:
I have a case of a 24 year old white female referred for possible
myelodysplastic syndrome but didn't fit the picture. Since last May her
white count has increased from 6.4 to 8.8. 75% of the peripheral blood
white cells are lymphocytes and almost all T-cells. Examination of a
peripheral smear reveals "reactive" granular lymphgocytes, neutropenia, and
moderate aniso and poikilocytosis. The bone marrow is hypercellular with
M:E of 3-5:1. Megas are normal. There is a left shift in granulocytic and
erythroid maturation. The biopsy shows a moderate sized lymphoid
collection.
Flow: 75% lymphocytes with 97% T-cells. Approximately 70% of the
lymphocytes are CD3+ T-cells with abnormally dim CD2, CD5 and CD7
expression; bright CD8; negative for CD56 and CD16 as well as + for CD38
and HLADR. They are alpha beta T-cells.
I think this is highly abnormal and I bet malignant. Any comments?
Maryalice Stetler-Stevenson
Lab of Path, NCI, NIH
CD ROM Vol 2 was produced by staff at the Purdue University Cytometry Laboratories
and distributed free of charge as an educational service to the cytometry community.
If you have any comments please direct them to Dr. J. Paul Robinson, Professor & Director, PUCL,
Purdue University, West Lafayette, IN 47907. Phone:(317) 494-0757; FAX (317) 494-0517; Web http://www.cyto.purdue.edu
EMAIL robinson@flowcyt.cyto.purdue.edu
