Furukawa Y, Tanaka K, Hasuike T, Hirai M, Masuzawa K, Ohira H, Ota K, Yasui Y, Nakao Y, Inoue T
Department of Laboratory Medicine, Osaka City University Medical School.
Rinsho Byori. 1991 May;39(5):557-61.
A 33-year-old man was hospitalized because of thrombocytopenia and severe splenomegaly. On admission 78% of peripheral lymphoid cells were abnormally large, with pale cytoplasm. Flow cytometry of the abnormal lymphocytes showed that they expressed CD 2, CD 3, CD 11, CD 16, and CD 56, but not CD 4 nor CD 8, so they were T-cell large granular lymphocytes (T-LGL). Abnormal lymphocytes obtained from a lymph node expressed CD 2, CD 16, CD 38, and CD 56, but not CD 3, CD 4, and CD 8, so they were natural killer(NK) cells. Splenectomy was performed and the operative specimen showed diffuse infiltration of pleomorphic lymphocytes, probably chronic lymphocytic leukemia cells. After splenectomy, the platelet count returned to normal but the lymphocytosis continued. Two years after discharge, chemotherapy was done because of thrombocytopenia and hepatomegaly. The patient died of disseminated intravascular coagulation arising from sepsis. The differences and similarities between peripheral and lymph-node lymphocytes suggest that LGL and NK cells may be differentiated from the same kind of cell, somewhat differentiated from stem cells.
一名33岁男性因血小板减少和严重脾肿大入院。入院时，78%的外周淋巴细胞异常增大，细胞质苍白。对异常淋巴细胞进行流式细胞术检测显示，它们表达CD2、CD3、CD11、CD16和CD56，但不表达CD4和CD8，因此它们是T细胞大颗粒淋巴细胞（T-LGL）。从淋巴结获取的异常淋巴细胞表达CD2、CD16、CD38和CD56，但不表达CD3、CD4和CD8，因此它们是自然杀伤（NK）细胞。进行了脾切除术，手术标本显示多形性淋巴细胞弥漫浸润，可能是慢性淋巴细胞白血病细胞。脾切除术后，血小板计数恢复正常，但淋巴细胞增多持续存在。出院两年后，因血小板减少和肝肿大进行了化疗。患者死于败血症引起的弥散性血管内凝血。外周淋巴细胞和淋巴结淋巴细胞之间的异同表明，LGL和NK细胞可能源自同一种细胞，与干细胞有一定程度的分化。
