Dear flow cytometry group, I have been unable to find literature pertaining to the unusual findings in one of our cases and was wondering if any of you have ideas on a diagnosis. The patient is male, about 60 years old with supraclavicular lymphadenopathy and possible history of cat scratch disease. Flow cytometry of lymph node cells shows that about 20% of the lymphocytes are CD3-CD4+, CD3-CD8-, CD7-, CD2+ and CD5+. These CD3-CD4+ cells are CD14- and bright CD4+, unlike monocytes. The remainder of the lymphocytes are a mix of T cells with the usual markers and about 24% B lymphocytes with a normal kappa:lambda ratio. About 60% of all lymphs are HLA-DR+ and 29% are expressing CD25. Histology appears to show reactive morphology and no apparent Reed Sternberg cells. We suspect a lymphoma, but the morphology does not show an obvious abnormal lymphoid population. Has anyone seen this CD3-CD4+ phenotype in any reactive conditions? Is it necessary to send the sample out for T cell gene rearrangement? Thank you for your help, Lucy Kimura Flow Cytometry Tripler Army Med. Ctr. TAMC, Hawaii lucille_h.kimura@tamc.chcs.amedd.army.mil
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