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Case Reports in Hematology
Volume 2017, Article ID 5873015, 7 pages
https://doi.org/10.1155/2017/5873015
Case Report

γδ T-Cell Acute Lymphoblastic Leukemia/Lymphoma: Discussion of Two Pediatric Cases and Its Distinction from Other Mature γδ T-Cell Malignancies

1Department of Pathology and Translational Pathobiology, LSU Health Shreveport, Shreveport, LA, USA
2Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA

Correspondence should be addressed to Eric X. Wei; moc.oohay@iewxcire

Received 9 June 2017; Revised 31 July 2017; Accepted 14 August 2017; Published 24 September 2017

Academic Editor: Marie-Christine Kyrtsonis

Copyright © 2017 Eric X. Wei et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gamma delta () T-cell antigen receptor (TCR) expression and its related T-cell differentiation are not commonly reported in T-cell acute lymphoblastic leukemia/lymphoma (T-ALL). Here we report two pediatric T-ALL cases and present their clinical features, histology, immunophenotypes, cytogenetics, and molecular diagnostic findings. The first patient is a two-year-old girl with leukocytosis, circulating lymphoblasts, and a cryptic insertion of a short-arm segment at 10p12 into the long-arm segment of 11q23 resulting in an MLL and AF10 fusion transcript, which may be the first reported in T-ALL. She responded to the chemotherapy protocol poorly and had persistent diseases. Following an allogeneic bone marrow transplant, she went into remission. The second patient is an eleven-year-old boy with a normal white cell count, circulating blasts, and a normal karyotype, but without any immature cellular markers by flow cytometric analysis. He responded to the chemotherapy well and achieved a complete remission. These cases demonstrate the diverse phenotypic, cytogenetic, and molecular aspects of T-ALL. Early T-precursor- (ETP-) ALL and their differential diagnosis from other mature T-cell leukemia/lymphomas are also discussed.