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Blood, 1 January 2002, Vol. 99, No. 1, pp. 268-274
NEOPLASIA
Distinct bone marrow findings in T-cell granular lymphocytic
leukemia revealed by paraffin section immunoperoxidase stains for CD8,
TIA-1, and granzyme B
William G. Morice,
Paul J. Kurtin,
Ayalew Tefferi, and
Curtis A. Hanson
From the Divisions of Hematopathology and Hematology,
Mayo Clinic, Rochester, MN.
Unlike other leukemia types in which the bone marrow findings are
diagnostic, the bone marrow pathology of T-cell granular lymphocytic
leukemia (GLL) is subtle and ill-defined. In this study, bone marrow
biopsy specimens from 36 patients with T-cell GLL and from 25 control
patients with cytopenias and relative or absolute increases in blood
large granular lymphocytes were studied by immunohistochemistry using
antibodies to the cytolytic lymphocyte antigens CD8, CD56, CD57, TIA-1,
and granzyme B. The goals were to clarify the bone marrow pathology of
T-cell GLL and to refine the diagnostic criteria for T-cell
GLL. Most bone marrow specimens from the T-cell GLL patients contained
interstitially distributed clusters of at least 8 CD8+
(83%) or TIA-1+ (75%) lymphocytes or clusters of at least
6 granzyme B+ (50%) lymphocytes. Interstitial clusters of
CD8+, TIA-1+, or granzyme B+ cells
were present in 36%, 12%, and 0%, respectively, of the control bone
marrows (all values significantly different, P < .001).
An additional T-cell GLL disease-specific finding was the presence of
linear arrays of intravascular CD8+, TIA-1+, or
granzyme B+ lymphocytes, found in 67% of cases of T-cell
GLL and in none of the 25 control samples (P < .001).
Staining for CD56 and CD57 was noncontributory. These findings clarify
the bone marrow histopathology of T-cell GLL and provide an additional
tool by which the discrete, abnormal lymphocyte population required for
a diagnosis of T-cell GLL can be identified.
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