53yrs old male underwent threpine biopsy.
HISTORY: Hypersplenism. Agranulocytosis (from 2006 09). Recurrent infections/abscesses in the leg.
CLIN DATA: Hb 113-115G/L; LEU 1,66-2,54 x 1000000000/L; GRANULOCYTES (NEUTR) 0,2-0,37x 1000000000/L; LDH 251 U/L; SPLEEN 14CM.
FLOW: Myeloid region: 1%; monocyte region 11%;
Lymphocyte region: 16%: T CD3+ (88%), T CD4+ (45%), T CD8+ (43%), B CD19+ (8%), NK CD16+ (8%); CD4/CD8~1.
HISTO: Diffuse interstitial T infiltration with some residual/reactive? follicles and lot of eos and mastocytes.
IH: CD3+ CD2+ CD7-/+ CD5+ CD8+ CD4- GranzymB-/+, Perforin+, CD30/CD56/CD10-, CD57+ 10% (maybe nonneoplastic, interstitial), EBV LMP1(-)(megas only), CD21+ FDC network is absent.
PROPOSAL: T LYMPHOMA/LEUKAEMIA, MOST PROBABLY LARGE GRANULAR LYMPHO LAUKAEMIA.
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