How I diagnose large granular lymphocytic leukemia.

IF 2.3 4区医学 Q2 PATHOLOGY

American journal of clinical pathology Pub Date : 2024-06-01 DOI:10.1093/ajcp/aqae064

Min Shi, William George Morice

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引用次数: 0

Abstract

Objectives: Large granular lymphocytic leukemia (LGLL) represents a rare neoplasm of mature T cells or natural killer (NK) cells, with an indolent clinical course. Diagnosing LGLL can be challenging because of overlapping features with reactive processes and other mimickers.

Methods: By presenting 2 challenging cases, we elucidate the differentiation of LGLL from its mimics and highlight potential diagnostic pitfalls. A comprehensive review of the clinicopathologic features of LGLL was conducted.

Results: Large granular lymphocytic leukemia displays a diverse spectrum of clinical presentations, morphologies, flow cytometric immunophenotypes, and molecular profiles. These features are also encountered in reactive conditions, T-cell clones of uncertain significance, and NK cell clones of uncertain significance.

Conclusions: In light of the intricate diagnostic landscape, LGLL workup must encompass clinical, morphologic, immunophenotypic, clonal, and molecular findings. Meeting major and minor diagnostic criteria is imperative for the accurate diagnosis of LGLL.

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我是如何诊断大颗粒淋巴细胞白血病的？

研究目的大颗粒淋巴细胞白血病（LGLL）是一种罕见的成熟T细胞或自然杀伤细胞（NK）肿瘤，临床病程缓慢。由于大颗粒淋巴细胞白血病的特征与反应性过程和其他模仿者重叠，因此诊断大颗粒淋巴细胞白血病具有挑战性：方法：通过介绍两例具有挑战性的病例，我们阐明了 LGLL 与其模仿者的区别，并强调了潜在的诊断陷阱。我们还对 LGLL 的临床病理特征进行了全面回顾：大颗粒淋巴细胞白血病的临床表现、形态、流式细胞免疫分型和分子特征多种多样。这些特征在反应性条件、意义不明的 T 细胞克隆和意义不明的 NK 细胞克隆中也会出现：鉴于诊断情况错综复杂，LGLL 的检查必须包括临床、形态学、免疫分型、克隆和分子检查结果。符合主要和次要诊断标准是准确诊断 LGLL 的必要条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of clinical pathology 医学-病理学

CiteScore

7.70

自引率

2.90%

发文量

367

审稿时长

3-6 weeks

期刊介绍： The American Journal of Clinical Pathology (AJCP) is the official journal of the American Society for Clinical Pathology and the Academy of Clinical Laboratory Physicians and Scientists. It is a leading international journal for publication of articles concerning novel anatomic pathology and laboratory medicine observations on human disease. AJCP emphasizes articles that focus on the application of evolving technologies for the diagnosis and characterization of diseases and conditions, as well as those that have a direct link toward improving patient care.