Adult T‐cell leukaemia/lymphoma featuring a large granular lymphocyte leukaemia morphologically

Sakamoto, Yuki; Kawachi, Yasunori; Uchida, Tatsuo; Abe, Takafumi; Mori, Masaharu; Setsu, Kojun; Indo, Naohito

doi:10.1111/j.1365-2141.1994.tb04745.x

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…The morphological characteristics of LGLs in peripheral blood have been reported by several authors (Ohno et al, 1989;Loughran & Starkebaum, 1987;Sakamoto et al, 1994;Gentile et al, 1994;Kwong et al, 1995); however, LGL Large granular lymphocytes showing abundant cytoplasm with coarse azurophilic granules in a peripheral blood smear (A and B: case 5), elongated, bizarre-looking granular atypical lymphoid cells with basophilic cytoplasm in the bone marrow (C and D: case 5; E and F: case 4; G: case 1; H: case 2) and a haemophagocyte (I: case 4). In all five cases an increase in haemophagocytes similar to this one were observed in the periphery of bone marrow smears.…”

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confidence: 56%

Haemophagocytic lymphohistiocytosis in association with granular lymphocyte proliferative disorders in early childhood: characteristic bone marrow morphology

et al. 1997

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Summary. Five paediatric cases of haemophagocytic lymphohistiocytosis (HLH) which showed proliferation of granular atypical lymphocytoid cells in bone marrow are reported. All cases were girls aged 8 months to 4 years who had marked hepatosplenomegaly. Marker analysis on peripheral blood mononuclear cells revealed an increase in the CD3 þ HLADR þ subset in three cases and the CD3 ¹ CD56 þ subset in one case. An Epstein-Barr virus genome was detected in three cases, and monoclonality was confirmed in two cases. A characteristic morphology of large granular lymphocytes (LGL) was identified, with elongated bizarre features that resembled horsetail-, tadpole-, cucumber-or shooting star-type configurations on the bone marrow smear. Serum concentrations of soluble interleukin-2 receptor and interferon-gamma were elevated in all cases. All five cases required multi-agent chemotherapy which resulted in two complete remissions, two partial remissions and one no response. Refinement of treatment is required for these paediatric GLPD cases which probably comprise a specific high-risk subgroup among secondary HLH patients which had previously escaped notice.

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confidence: 56%

Haemophagocytic lymphohistiocytosis in association with granular lymphocyte proliferative disorders in early childhood: characteristic bone marrow morphology

et al. 1997

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“…In addition to polylobed cells, some blastic cells with basophilic cytoplasm are almost always seen in blood films of ATL [6]. A few cases with presence of bizarre gianT-cells or large granular lymphocytes [7, 8] have also been reported, and shown to have aggressive clinical features and a poor prognosis. …”

Section: Discussionmentioning

confidence: 99%

Adult T-Cell Leukemia/Lymphoma with CLL-Like Morphology—A Case Report

Tageja

Mohammad

Bentley

et al. 2010

Case Reports in Medicine

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Adult T-cell Leukemia/Lymphoma (ATL) is rarely seen in the U.S. and Europe, usually limited to African Americans from the southeastern U.S. and immigrants from HTLV-1 endemic areas. Reaching an accurate and timely diagnosis of ATL in such nonendemic areas can be challenging, owing to limited exposure, diverse manifestations, and varying cell morphology. We present a case of chronic adult T-cell leukemia (ATL) with Chronic Lymphocytic Leukemia- (CLL-) like morphology that remained untreated for ten years and then developed treatment refractory acute ATL crisis.

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“…Several cases with unusual morphological features of ATL cells, i.e. bizarre giant cells or large granular lymphocytes, have been reported (Kamihira et al , 1993; Sakamoto et al , 1994). These cases showed aggressive clinical features and poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to polylobed cells, some blastic cells with basophilic cytoplasm are almost always seen in blood films of ATL (Bennett et al , 1989). Several cases with unusual morphological features of ATL cells have been reported (Kamihira et al , 1993; Sakamoto et al , 1994). We describe here that the diversity of morphology in ATL apparently correlated with genotype, phenotype and behaviour of the disease.…”

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confidence: 99%

Diversity of leukaemic cell morphology in ATL correlates with prognostic factors, aberrant immunophenotype and defective HTLV‐1 genotype

Tsukasaki

Imaizumi²,

Tawara³

et al. 1999

Br J Haematol

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Summary.To investigate the diversity of morphology in adult T-cell leukaemia/lymphoma (ATL) and its possible association with the pathophysiology of ATL, we selected 36 acute cases and 14 chronic cases phenotypically confirmed to have >90% ATL cells in peripheral blood mononuclear cells. Prototype ATL cells were observed in all cases, although the percentage of all lymphoid cells varied considerably (48·9 Ϯ 23·8 in acute type, 29·6 Ϯ 18·9 in chronic type; P ¼ 0·015). Chronic lymphocytic leukaemia (CLL)-like morphology with round nuclei was more frequent in chronic type than in acute type (52·0 Ϯ 24·9% v 16·6 Ϯ 13·1%; P < 0·0001). Unusual morphology (UM; lymphoblastic, vacuolated, granular pleomorphic or large cells) was more frequent in acute type than in chronic type (20·1 Ϯ 18·7% v 2·7 Ϯ 3·2%; P < 0·0001). Furthermore, there were significant negative and positive correlations of % CLL-like cells and % UM cells respectively, with serum LDH level, hypercalcaemia, performance status, and total number of involved lesions. Cases with aberrant immunophenotype (n ¼ 6) or defective HTLV-1 integration (n ¼ 22) showed lower % CLL-like cells and higher % UM cells than other cases, respectively. Cases with >50% CLL-like cells (n ¼ 7; all chronic type) were younger (53·1 Ϯ 12·2 v 66·9 Ϯ 10·6 years; P ¼ 0·038) and showed longer acute-crisis free survival (mean: 16·7 v 3·0 years; P ¼ 0·012) than chronic cases with <50% CLL-like cells. These results suggest that diversity in genotype, phenotype, morphology and behaviour of ATL are closely associated, and that CLL-like morphology is a good prognostic factor for chronic type.

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Adult T‐cell leukaemia/lymphoma featuring a large granular lymphocyte leukaemia morphologically

Cited by 12 publications

References 11 publications

Haemophagocytic lymphohistiocytosis in association with granular lymphocyte proliferative disorders in early childhood: characteristic bone marrow morphology

Haemophagocytic lymphohistiocytosis in association with granular lymphocyte proliferative disorders in early childhood: characteristic bone marrow morphology

Adult T-Cell Leukemia/Lymphoma with CLL-Like Morphology—A Case Report

Diversity of leukaemic cell morphology in ATL correlates with prognostic factors, aberrant immunophenotype and defective HTLV‐1 genotype

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