Parallel tubular array構造の顆粒を有し，IgG Fcレセプター陽性のT-CLL (Tγ-CLL)の1例

抄録

A 69-year-old male was incidentally found to have leukocytosis. No lymphadenopathy or hepatosplenomegaly was found, but the peripheral blood leukocyte count was 21,000/mm³, 84% of which was leukemic lymphocytes. These leukemic cells contained characteristically many cytoplasmic azurophilic granules in May-Giemsa stained smears. Ultrastructurally most of these granules showed the structures referred to as parallel tubular arrays (PTA). These cells formed E rosette and also bound ox erythrocyte coated with IgG, thus exhibiting identical surface markers with T lymphocytes bearing Fc receptors for IgG (Tγ cells). The clinical and hematological features of the present case were different from those of “adult T cell leukemias” reported in Japan. It seemed sure that this case could be diagnosed as Tγ-CLL. Apparently Tγ-CLL has not been reported in Japan, so far while Mackenna et al. reported four cases of T-CLL, the leukemic cells of which contained PTA and carried a IgG Fc receptor.
Morphologic and functional difference bitween Tγ-CLL cells and Tγ cells separated from normal peripheral lymphocytes was also discussed.