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A morphologic and immunologic study of the large granular lymphocyte in
neutropenia with T lymphocytosis
WC Chan, I Check, C Schick, RK Brynes, J Kateley and EF Winton
We report four patients with expansion of a unique population of
lymphocytes that is consistently associated with neutropenia. Two patients
also had rheumatoid arthritis and autoantibodies. The lymphocytes contained
many cytoplasmic azurophilic granules, which possessed strong acid
phosphatase activity. Multiple cytoplasmic parallel tubular arrays were
observed ultrastructurally. These granular lymphocytes showed the T
suppressor/cytotoxic cell phenotype (E+, OKT3+, OKT8+, OKT4-, OKM1-, OKI1-)
and exhibited antibody-dependent cell-mediated cytotoxic activity but
little or no natural killer cytotoxicity. They did not respond to recall
antigens, concanavalin A, or pokeweed mitogen, but the cells from one
patient did respond to phytohemagglutinin. No in vitro suppressor cell
activity on mitogenic responses of allogeneic cells and on mixed lymphocyte
cultures could be demonstrated. There was no evidence of suppression of
immunoglobulin synthesis in vivo. It is uncertain that the expansion of
this subset of lymphocytes represents a leukemic process. Their constant
association with neutropenia, however, raises the possibility that the
increase in large granular lymphocytes and neutropenia might be
pathogenetically related.
Volume 63,
Issue 5,
pp. 1133-1140,
05/01/1984
Copyright © 1984 by The American Society of Hematology
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