Flow cytometry (FC) facilitates diagnosis of peripheral T-cell non-Hodgkin lymphoma (T-NHL), but overlapping features between reactive and neoplastic T-cell proliferations often hamper a rapid assessment. One hundred forty peripheral blood samples submitted to diagnostic FC for T-cell immunophenotyping were retrospectively analyzed. A T-cell population with a conspicuous aberrant surface epitope expression pattern was observed in 18 cases and diagnostic follow up was performed. The aberrant T-cell population exhibited a low scatter profile, a CD7-negative/low, CD8-low and CD3-positive immunophenotype, and monoclonal T-cell receptor expansion. T-NHL was ruled out by follow up in all cases. Epstein-Barr virus infection was diagnosed in 12 cases, cytomegalovirus infection in three cases; one patient had been vaccinated. The irregular subpopulation disappeared spontaneously within days or weeks. We describe a novel peripheral blood T-cell subpopulation with a low light scatter and CD8-low, CD7-negative/low and CD3-positive marker expression profile, which indicates reactive T-cell expansion in patients who present with peripheral lymphadenopathy and/or B symptoms.
Peripheral T-cell lymphoma is a rare disease and remains a diagnostic challenge in some cases. Abnormally diminished expression of the pan T-cell markers (i.e. CD3, CD5, CD7, CD2) in flow cytometric immunophenotyping is a hallmark of peripheral T-cell lymphomas. CD3 is often used as a marker for mature T-lymphocytes and loss of cell surface CD3 on T-cells is a typical feature of the angioimmunoblastic T-cell lymphoma (Serke et al., 2000).
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