Pathology · Hematological Malignancies (Leukemias, Lymphomas, Myeloma)

Flow cytometry in a patient with T-cell prolymphocytic leukemia (T-PLL) is most likely to show which immunophenotype?

  • A CD3+, CD4+, CD8−, TCL1+ with complex karyotype including inv(14)(q11;q32)
  • B CD3+, CD4−, CD8+, CD56+ with large granular lymphocyte morphology
  • C CD3−, CD4+, CD25+, CD127low (regulatory T-cell phenotype)
  • D CD3+, CD4+, CD7+, CD25+ with HTLV-1 positivity
Correct answer: A. CD3+, CD4+, CD8−, TCL1+ with complex karyotype including inv(14)(q11;q32)

Explanation

T-cell prolymphocytic leukemia (T-PLL) characteristically shows CD3+, CD4+ (in ~60%), TCL1 overexpression, and the chromosomal hallmark inv(14)(q11;q32) or t(14;14)(q11;q32) activating the TCL1A oncogene. Option B describes T-LGL leukemia (NK/T-LGL). Option C describes Tregs. Option D describes adult T-cell leukemia/lymphoma (ATLL), which is HTLV-1 associated.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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