case_images: PMC4944328_01
case_images: Peripheral blood smear shows large granular lymphocyte (a) [100x, May-Grunwald-Giemsa (MGG) stain]; Bone marrow aspirate shows erythroblastopenia and large granular lymphocytes (b) (100x, MGG stain); trephine biopsy shows reactive lymphoid nodules (c) (20x, H&E stain) composed of CD20+ cells (d) (20x) and CD3+ cells (e) (20x); CD8+ cells in the interstitium (f) (20x)
case_images: JPGM-62-40-g001.jpg
case_images: PMC4944328_01_JPGM-62-40-g001.jpg
case_images: F1
case_images: Peripheral blood (PB) smear showed absolute lymphocytosis (6993/mul) with >90% of them being LGLs [Figure 1a]. BM trephine biopsy showed multiple reactive lymphoid nodules composed of both B cells and T cells, as revealed by immunohistochemistry [Figure 1b-f].
case_images: Clinical course of the patient. (MMF - mycophenolate mofetil; CsA - cyclosporine)
case_images: JPGM-62-40-g002.jpg
case_images: PMC4944328_01_JPGM-62-40-g002.jpg
case_images: F2
case_images: The subsequent clinical course is summarized in Figure 2.
case_images: Flow cytometry performed on peripheral blood. CD3+ cells (92% of lymphocytes) were gated. 48% of T cells were gammadelta TCR+ (3a), which were CD2+CD7+ (not shown), CD8+ (variable) (3a), CD5- (3b), CD4- (3c), CD57+(variable), CD56- (3d), and CD16+ (not shown)
case_images: JPGM-62-40-g003.jpg
case_images: PMC4944328_01_JPGM-62-40-g003.jpg
case_images: F3