Morphology, surface markers, and in vitro responses of a human leukemic T cell

Large granular lymphocyte (LGL) lymphoproliferative diseases: naturally cytotoxic tumors in man and experimental animals

It has recently become clear that in the spleen and blood of both rodents and man that a unique subpopulation of lymphocyte is the mediator of virtually all of the inherent natural killer (NK) and antibody-dependent cell-mediated cytotoxic (ADCC) activity. Because of their large size, eccentric kidney-shaped nucleus and prominent cytoplasmic granules, these cytotoxic cells, termed large granular lymphocytes (LGL), can be readily identified in Geimsa stained cytocentrafuge preparations. Unfortunately, the relatively low numbers of these cells in normal lymphoid tissues has made the detailed analysis of LGL quite difficult. Recently however, a number of investigators have reported both rodent and human leukemias or leukocytosis in which there was an abnormally high number of circulating lymphocytes with either the appearance and/or function of LGL. The present manuscript reviews this literature with an emphasis on the biological and clinical characteristics of this lymphoproliferative disease. Emphasis is also placed on the usefulness of these cells for the detailed analysis of LGL morphology and function.

Adult T-cell leukemia in Japan: an ultrastructural study

An electron microscopic study of adult T-cell leukemia, which might be a new distinct disease entity of T-cell malignancies, is presented. The most characteristic feature of adult T-cell leukemia was an extremely irregular nucleus with condensed heterochromatin in the nuclear periphery, the greater part of which was very similar to the small-cell variant form of Sézary syndrome, although some nuclei were similar to normal-appearing lymphocytes or atypical lymphoid cells with slightly indented nuclei or Sézary cells. Nuclear pockets containing tubuloreticular structures and filamentous structures etc., were also characteristic. Regarding the cytoplasmic features, the appearance of clustered dense bodies seemed to be a distinguishing feature of adult T-cell leukemia. Tubuloreticular structures were also observed in some cases. The nature of the test tube-shaped or ring-shaped forms in rough endoplasmic reticulum, which appeared in one case, is not clear.

The immunological and cytochemical characterization of T-cell lymphoproliferative diseases

Surface markers, terminal transferase, cytochemical staining, and function of peripheral blood lymphocytes were examined in nine patients with T-cell lymphoproliferative disease. Anti-T-cell antiserum proved useful in characterizing the phenotypes of the abnormal cells when only a minority of the abnormal cells formed E-rosettes. Anti-B-cell antiserum was consistently unreactive with the abnormal cells. Terminal transferase was elevated in T-cell ALL but low in T-cell CLL, lymphoma-leukemia, or Sézary syndrome. Lymphocyte proliferative response to nonspecific mitogens was generally depressed as was the response to allogeneic cells. The cells also failed to stimulate in mixed lymphocyte culture, implying a lack of Ia antigens on their surface. Acid phosphatase stain was positive in three patients tested. Peroxidase and esterase stains were negative, whereas PAS was positive in five of eight patients tested. Prognosis in general, regardless of the clinical picture, (ie, acute, chronic, or lymphoma-leukemia), was poor with seven of the nine patients dying within 14 months of diagnosis. Therefore, the use of anti-T-cell antisera and the E-rosette surface marker should be used to characterize the phenotype of the malignant cells in lymphoproliferative disease to enable more vigorous treatment of those that are of T-cell origin and that therefore carry a poor prognosis.

Small lymphocyte T-cell leukemia in the adult

A 49-year-old man is described with morphologic T cell chronic lymphocytic leukemia, whose clinical course, however, progressively deteriorated with central nervous system involvement, resistance to treatment and death within eight months. In addition to widespread organ invasion by leukemic cells there was depression of cellular immunity. The leukemic lymphocytes showed an aberrant response to mitogens, and despite undetectable Ia-like surface antigens were able to stimulate allogeneic cells in the mixed leucocyte reaction. From this and similar cases reviewed herein, it appears that the syndrome of small T-lymphocyte leukemia of the adult is a rapidly aggressive and resistant disease with characteristic clinical and laboratory findings.

A case of T-cell lymphoma with Sézary cells in the blood and bone marrow accompanied by peripheral T and B lymphocytosis

A case of T-cell lymphoma occurred in a man, aged 66, whose symptoms started as itching and the appearance of 1-2 cm indurated plaques with central pustules on the skin of the trunk and face. A few months later generalized lymphomas and splenomegaly were present. Investigations of the lymphocytic subpopulations in situ in fresh frozen sections of lymphomas and skin showed only T cells. Samples of blood and bone marrow disclosed lymphocytosis and Sézary cells. Both T and B lymphocytes were definitely increased in the blood. The value of tissue studies in analyzing lymphocytic subpopulations is emphasized as a differential diagnostic aid in classifying lymphomas. A relationship between the T-cell neoplasia and the T and B lymphocytosis to mycosis fungoides and the Sézary syndrome is discussed.