case_images: PMC4818784_01
case_images: (a) T-PLL (cerebriform variant)-Peripheral blood smear showing prolymphocytes with cerebriform nucleus, inconspicuous nucleolus and basophilic cytoplasm with vacuolations; (b) CLPD-NK- Bone marrow aspirate smear showing intermediate-sized lymphocytes with condensed nuclear chromatin and moderate amount of cytoplasm with fine granules; (c) T-LGL leukemia - Peripheral blood smear showing lymphocytes with moderate cytoplasm and coarse granules; (d) Hepatosplenic gamma/delta T-NHL -Bone marrow aspirate showing atypical lymphoid cells with opened up chromatin, oval to round nuclei and moderate amount of cytoplasm. (May-Grunwald-Giemsa, 1000X)
case_images: IJHOSCR-10-13-g001.jpg
case_images: PMC4818784_01_IJHOSCR-10-13-g001.jpg
case_images: F1
case_images: In one case of T-PLL, the prolymphocytes were smaller in size with cerebriform nucleus having inconspicuous nucleolus and basophilic cytoplasm with vacuolations (cerebriform variant of T-PLL) (Figure 1 a). Both cases of CLPD-NK showed intermediate-sized lymphocytes with condensed nuclear chromatin and moderate amount of cytoplasm with fine granules (Figure 1 b). The single case of T-LGL leukemia showed the presence of large atypical lymphocytes with moderate cytoplasm and coarse granules (Figure 1 c). A case of hepatosplenic gamma/delta T-NHL showed atypical lymphoid cells with oval to round nuclei and moderate amount of cytoplasm (Figure 1 d).
case_images: Hepatosplenic gamma/delta T-NHL- Bone marrow biopsy showing intrasinusoidal pattern of infiltration [Hematoxylin and Eosin, (a) 200X, (b) 400X]. Immunohistochemistry - (c) CD34- highlighting the vessels, (d) CD3- showing tumor cells within vessels (1000X)
case_images: IJHOSCR-10-13-g002.jpg
case_images: PMC4818784_01_IJHOSCR-10-13-g002.jpg
case_images: F2
case_images: Intrasinusoidal infiltration was seen in 1 case of CLPD-NK cell and single case of hepatosplenic gamma/delta T-NHL (Figure 2). 
case_images: Flow cytometric dot plots of case of (a) T-PLL: Positive markers are- CD3, CD4, CD7, CD2 and TCR-alpha/beta; (b) CLPD-NK: Positive markers are- CD56, CD16, CD2 and CD7. In addition small proportion normal T-lymphoid cells are also seen; (c) LGL: Positive markers are- CD3, CD8, CD5, CD56 and CD16; (d) Hepatosplenic gamma/delta: Positive markers are CD3, CD7, CD2, CD56 and CD16
case_images: IJHOSCR-10-13-g003.jpg
case_images: PMC4818784_01_IJHOSCR-10-13-g003.jpg
case_images: F3