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June 1991

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

Author Affiliations

Department of Dermatology; Department of Hematology Royal Liverpool Hospital Prescot Street, PO Box 147 Liverpool L69 3BX, England

Arch Dermatol. 1991;127(6):909-910. doi:10.1001/archderm.1991.01680050155026

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:

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