Rossi Davide, Franceschetti Silvia, Capello Daniela, De Paoli Lorenzo, Lunghi Monia, Conconi Annarita, Gaidano Gianluca
Division of Hematology, Department of Clinical and Experimental Medicine and IRCAD, Amedeo Avogadro University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy.
Am J Hematol. 2007 Dec;82(12):1103-5. doi: 10.1002/ajh.20981.
Lymphocytosis associated with viral infection is generally polyclonal or oligoclonal. In this article, we describe a case of transient monoclonal CD8+/CD57+ T-cell lymphocytosis with large granular lymphocyte (LGL) morphology occurring after primary CMV infection and review cases of virus-associated monoclonal CD8+ T-cell expansions reported in the literature. Several clinical features shared by virus-associated monoclonal CD8+ T-cell expansions suggest the reactive nature of the lymphocytosis. Based on this, our case report and those reported in the literature support the notion that T-cell receptor clonality per se is not necessarily indicative of malignancy. These observations further corroborate the need for a close follow-up before assigning the diagnosis of LGL leukemia to individuals developing monoclonal CD8+ T-cell expansions.
与病毒感染相关的淋巴细胞增多通常是多克隆或寡克隆性的。在本文中，我们描述了一例原发性巨细胞病毒感染后出现的具有大颗粒淋巴细胞（LGL）形态的短暂性单克隆CD8⁺/CD57⁺ T细胞淋巴细胞增多病例，并回顾了文献中报道的病毒相关单克隆CD8⁺ T细胞扩增病例。病毒相关单克隆CD8⁺ T细胞扩增共有的几个临床特征提示淋巴细胞增多具有反应性本质。基于此，我们的病例报告及文献中报道的病例均支持这样一种观点，即T细胞受体克隆性本身不一定意味着恶性肿瘤。这些观察结果进一步证实，对于出现单克隆CD8⁺ T细胞扩增的个体，在诊断为LGL白血病之前需要密切随访。
