Tracing absolute lymphocytosis to T-large granular lymphocytic leukaemia in elderly: a flowcytometry based case report

Abena Hidangmayum; Beena Chandrasekhar; Nagarjun Sai Jaine; Kailash Singh Mehra; Ravindra Prasad Joshi

doi:10.18203/2320-6012.ijrms20254393

Authors

Abena Hidangmayum Department of Flowcytometry, National Reference Laboratory, Dr Lal Pathlabs, Rohini, New Delhi, India https://orcid.org/0000-0001-5640-7895
Beena Chandrasekhar Department of Flowcytometry, National Reference Laboratory, Dr Lal Pathlabs, Rohini, New Delhi, India
Nagarjun Sai Jaine Department of Flowcytometry, National Reference Laboratory, Dr Lal Pathlabs, Rohini, New Delhi, India https://orcid.org/0009-0007-1058-4109
Kailash Singh Mehra Department of Flowcytometry, National Reference Laboratory, Dr Lal Pathlabs, Rohini, New Delhi, India
Ravindra Prasad Joshi Department of Flowcytometry, National Reference Laboratory, Dr Lal Pathlabs, Rohini, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20254393

Keywords:

TRBC1, Chronic lymphoproliferative disease, T-Large granular lymphocyte leukaemia, Large granular lymphocytes, Flowcytometry

Abstract

T-cell large granular lymphocytic leukaemia (T-LGL leukaemia) is a rare, neoplastic proliferation of cytotoxic T cells, accounting for less than 5% of all chronic lymphoproliferative disease. Diagnosing T-LGLL can be challenging, particularly in distinguishing it from reactive lymphocytosis. Despite its indolent nature, T-LGL leukaemia remains incurable, highlighting the need for improved therapeutic strategies. The TRBC1 flow cytometric assay provides a rapid and reliable means of assessing T-cell clonality in patients with large granular lymphocytosis, facilitating diagnosis through detection of altered proportions of TRBC1⁺ αβ T cells. We report a case of T-LGL leukaemia with an immunophenotypic clonal T-cell, characterised as a CD4-/CD8+ T-cell, TCRαβ subset, exhibiting downregulation of CD5 and CD7, with expression of the NK Cell marker CD16.

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