T-cell prolymphocytic leukemia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qurrat-ul-ain Abid, M.D.[2], Maria Fernanda Villarreal, M.D. [3]

Overview

In T-cell prolymphocytic leukemia, the peripheral blood smear demonstrates the predominance of lymphocytes and high lymphocyte count (> 100 x 109/L).

Laboratory Findings

• Laboratory findings consistent with the diagnosis of T-cell prolymphocytic leukemia, include:

• High lymphocyte count (> 100 x 109/L)
• Anemia
• Thrombocytopenia
• Negative human T lymphotropic virus (HTLV) serology
• Peripheral Blood Smear demonstrated predominance of lymphocytes:
  • Typical variant:
    • Medium-sized lymphocytes
    • Condensed chromatin and a visible nucleolus
    • Round nucleus
    • Slightly basophilic cytoplasm
    • Cytoplasmic protrusion
  • Small cell variant
    • Small tumor cells with condensed chromatin
    • Small nucleolus visible by electron microscopy
  • Cerebriform (Sézary cell-like) variant
    • Irregular nuclear outline
    • Similar to cerebriform nucleus of Sézary cells seen in mycosis fungoides