CD4-positive DLBCL that is difficult to decipher by flow cytometry: a ‍case report

Abstract

A 70-year-old male came to our hospital’s Hematology Department suffering from platelet depletion. He presented with hypothyroidism, high blood pressure, chronic obstructive pulmonary disease, and hyperuricemia. A pathologic diagnosis of diffuse large B-cell lymphoma (DLBCL) was made on the basis of the reconstitution of the immunoglobulin heavy chain J_H. The abnormal cells in the bone marrow were blastlike cells and a few phagocytes. Flow cytometry is ‍useful for examination owing to the differential diagnosis of cells and ‍the determination of a therapeutic strategy and prognosis. The immunophenotypes of the lymphoma cells were CD1a−, CD2−, CD3−, CD4+, CD5+, CD7−, CD8−, ‍CD10−, CD11b−, CD13−, CD14−, CD19+, CD20+, CD25−, CD33−, CD34−, CD36+, CD38+, CD41−, CD56−, HLA−DR+, IgG−, IgA−, IgM−, IgD−, κ−, and λ−. It was difficult to decipher the results of flow cytometry when CD19 of ‍pan-B-cell markers and CD4 of T-cell markers were positive. R-CHOP was performed. Results showed that complete remission was achieved. We experienced a rare case of CD4-positive DLBCL.