An Unusual Case of T-Lymphocytic Leukemia With Coexpression of Helper and Suppressor Surface Markers

To the Editor.—  T-cell prolymphocytic leukemia (T-PLL) represents a rare form of lymphoproliferative disorder that carries a grave prognostic consequence. We describe an unusual presentation of a case, and we believe that the pattern of immunophenotypic expression of the leukemic cells provides a useful distinguishing feature from other forms of leukemias/lymphomas.

Report of a Case.—  An 84-year-old white man presented in June 1989 with a 6-week history of a florid nonblanching macular erythema affecting the face and upper chest only (Figure). Physical examination was unremarkable; there was neither lymphadenopathy nor hepatosplenomegaly.Laboratory findings revealed marked leukocytosis with an atypical lymphocytosis of 36.9 × 10⁹/L. The cytoplasm demonstrated deep basophilia, and the nuclei showed a regular outline with slight indentation. The nucleoli were inconspicuous under light microscopy. With the use of membrane marker analysis against a panel of monoclonal antibodies, the peripheral mononuclear cells demonstrated the following membrane markers: