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T-Cell Prolymphocytic Leukemia Accompanied by Plural M-Proteins with Myelodysplastic Syndrome in a Nonagenarian | OMICS International | Abstract
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

T-Cell Prolymphocytic Leukemia Accompanied by Plural M-Proteins with Myelodysplastic Syndrome in a Nonagenarian

Nagahito Saito1*, Katsuhiro Higashiura1, Kenta Honma1, Shinji Kurosawa1, Kazunori Ehata1, Tomoyuki Yanami1, Katsumi Katagiri1, Hiroyuki Sugiki2 and Hong Kean Ooi3,4*
1Internal Medicine, Nemuro City Hospital, Nemuro, Hokkaido, Japan
2Internal Medicine, Nemuro Kyoritsu Hospital, Nemuro, Hokkaido, Japan
3Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
4Veterinary Medicine, Yamaguchi University, Japan
Corresponding Authors : Nagahito Saito
Internal Medicine, Nemuro City Hospital
1-2, Ariisocho, Nemuro, 087-8686, Japan
Tel: 81-153-24-3201
Fax: 81-153-24-9693
E-mail: [email protected]
  Prof. Hong-Kean Ooi
Veterinary Medicine, National Chung Hsing University
250, Kuo Kuang Road, Taichung, 40227, Taiwan
Tel: (886)-4-2284-0895 ext. 509
Fax: (886)-4-2286-2073
E-mail: [email protected]
Received February 10, 2012; Accepted April 20, 2012; Published April 28, 2012
Citation: Saito N, Higashiura K, Honma K, Kurosawa S, Ehata K, et al (2012) T-Cell Prolymphocytic Leukemia Accompanied by Plural M-Proteins with Myelodysplastic Syndrome in a Nonagenarian. J Clin Case Rep 2:131. doi:10.4172/2165-7920.1000131
Copyright: © 2012 Saito N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

T-cell Pro-Lymphocytic Leukemia (T-PLL) is a rare disease caused by malignancy of mature post-thymic T-cell. Myelodysplastic Syndrome (MDS) is caused by abnormal differentiation of myeloid lineage cells resulting in myeloid leukemia. Both of these hematological disorders are frequently diagnosed in elderly persons. Myeloid lineage is believed to be situated at the position far from lymphoid one as it is regarded on a tree diagram about the blood cell maturation. We reported herein a rare case of T-PLL accompanied by plural M-proteins with MDS a nonagenarian. The 96 years old patient was admitted to our hospital because of lymphocytosis and abnormal lymphocytes. From the bone marrow aspirate, biopsy and hematological findings, abnormalities were observed in cells of three different lineages, namely, (i) neutrophils with hypersegmented-nuclei (ii) erythroblasts with nuclear division, large platelets and megakaryoblastic cells, and (iii) reticulum cells with phagocytosed iron in their cytoplasm. Lymphocytes showed CD3 (+), CD4 (±), CD5 (+), CD8 (+), CD10 (+), CD56 (-) and CD57 (-). Mast cells and large lymphocytic cells with nuclear pockets were also seen. Anti-HTLV-1 antibody was negative. Soluble IL-2 receptor was significantly elevated to 7910 U/ml. Both IgGλ and IgGκM-protein were detected. No Bence-Jones protein was detected in the urine. Chromosomal abnormality of 45 (X, 0) or loss of Y chromosome was also demonstrated. Due to his high age, it was difficult to classify his condition according to the conventional classification. Thus, what we had experienced is truly a rare case that coincidentally showed T-PLL and MDS with plural M-proteins.

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