Unusual case of granular lymphocytes (GL) proliferation: simultaneous reactive and neoplastic proliferation.
We report a case of a 55-year-old male with lymphoproliferative disease of granular lymphocytes. In the first year of follow-up reactive expansion of granular lymphocytes was observed during infectious episodes additionally to malignant proliferation. Histopathological studies revealed malignant lymphocytic infiltrations of the liver and gallbladder walls. The number of GL varied from 1.1 G/l to 17.8 G/l. Immunophenotyping studies showed surface phenotype CD3+, CD8+. There was markedly reduced NK cell function. The patient exhibited lack of severe parenchymal involvement, moderately increased white cell count (up to 21.0 G/l), severe neutropenia (0.06 G/l - 0.8 G/l) and recurrent infectious episodes.