Abstract
A pleomorphic adult Tγ-cell leukemia which showed many interesting manifestations including cellular morphological changes and immunological abnormalities was reported.
The patient was a 66-year-old man having lymphadenopathy, hepatosplenomegaly, pleural effusion and skin eruption. Leukemic cells in the peripheral blood possessed convoluted and lobulated nuclei, and in the pleural effusion had been transformed into blastoid cells, some of which simulated Hodgkin's cells or Reed-Sternberg's giant cells. These cells formed spontaneous rosettes with sheep erythrocytes and possessed IgG Fc receptor, but never had immunophagocytic function. Serum immunoglobulin levels were all depressed and unresponsiveness in several skin tests suggested decreased cell-mediated immunity as well. According to these results, leukemic cells were considered Tγ-cells with suppressor activity. The histological appearance of lymphnode specimen was highly pleomorphic, similar to that of reticulum cell sarcoma. The histological examination of the skin lesion revealed mild infiltration of leukemic cells into the upper dermis and formation of Pautrier's microabscess in the epidermis.
The patient was treated with prednisolone, cyclophosphamide and 6-MP, but finally died of pulmonary candidiasis on the 62nd hospital day.
