T-Cell Large Granular Lymphocytic Leukemia with Extremely Rare Immunophenotype (CD4/CD8 Double-Positive) Followed by Multiple Myeloma Diagnosis

<div>Peripheral blood smear (Wright’s stain, 100x) shows increased large granular lymphocytes, some of which showed irregular nuclear contours (a). Lymphocytosis is persistent and slowly progressive for more than 11 months of duration (b). Flow cytometry done on the PB (c) showing 37% T cells, including a subpopulation of CD4/CD8 double-positive T cells (10%) expressing TCR alpha/beta, CD57, and cTIA, and a showing dim expression of CD4 and CD7. FCM on PB for T-cell receptor V(β) region repertoire on CD4/CD8 double-positive population shows more than 70% of the cells fails to express any of the tested V(β) regions, suggestive of clonal population of T-LGLL (CD3+/CD4+/CD8+/CD57+) (d).</div>

Case Reports in Hematology

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Figure 1: T-Cell Large Granular Lymphocytic Leukemia with Extremely Rare Immunophenotype (CD4/CD8 Double-Positive) Followed by Multiple Myeloma Diagnosis 

Figure 1 | T-Cell Large Granular Lymphocytic Leukemia with Extremely Rare Immunophenotype (CD4/CD8 Double-Positive) Followed by Multiple Myeloma Diagnosis 