Hi Maryalice, 1. What do you do if you think you have an NK-LGL lymphoproliferative process? I haven't had a specimen before that I considered this diagnosis before. I would always check the TCR gamma/delta rearrangement, it may be rearranged even if CD3 is negative. 2. Have you seen this peripheral blood profile in a patient with marginal zone lymphoma or other plasmacytoid neoplasm? I haven't seen a similar case but we have recently had two patients with monoclonal lymphoplasmocytoid NHL that also had in the BM and lgl clonal proliferations (PRC confirmed) of CD8+ T cells. We have also seen an elderly woman who was diagnosed with LGL (NK phenotype) lymphoproliferative disorder and treated with steroids. A month later NK cells disappeared and AML developed. We thought that the NK cells were a sign of response towards developing leukemia. Best wishes Anna Anna Porwit Heamatopathology Lab. Department of Pathology Karolinska Hospital, Stockholm anpo@mb.ks.se tel.:+46-851774518 fax.:+46-851775843
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