Adult T-cell leukemia/lymphoma with an unusual CD1a positive phenotype

Cytometry B Clin Cytom. 2014 Jul;86(4):292-6. doi: 10.1002/cyto.b.21130. Epub 2013 Sep 30.

Abstract

Background: Acute T-cell leukemia lymphoma (ATLL) tumor cells generally express CD2/CD3/CD5, but lack CD7. These T cells are usually CD4+CD8- and strongly express CD25, although some variability in this basic pattern may be found. Here we report a case with a very unusual CD1a positive phenotype.

Methods: Samples from peripheral blood, bone marrow aspirate, lymph node, and cerebrospinal fluid obtained from a 45-year-old male patient with a T-cell lymphoproliferative disorder were immunophenotyped by multiparametric flow cytometry. Analysis of HTLV-I genome integration in tumoral cells was performed by PCR.

Results: Neoplastic T cells were cCD3, CD2/CD5/CD30/CD25, and CD1a positive, but CD3/CD7/CD4/CD8/CD34/CD10/TdT negative. Serology and integration of HTLV-I were positive.

Conclusion: To the best of our knowledge, CD1a expression has not been previously described in this entity. Its detection raised the differential diagnosis with acute T lymphoblastic leukemia. The rest of the phenotypic markers, the morphology of the neoplastic cells, and the demonstration of HTLV-I genome integration provided the final diagnosis.

Keywords: ATLL; CD1a.

Publication types

  • Case Reports

MeSH terms

  • Antigens, CD1 / analysis*
  • Flow Cytometry
  • Humans
  • Immunophenotyping
  • Male
  • Middle Aged
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / diagnosis*
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / immunology
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / metabolism*
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / virology

Substances

  • Antigens, CD1
  • CD1a antigen