How I diagnose large granular lymphocytic leukemia.
Min Shi1, William George Morice1
1Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, US.
American Journal of Clinical Pathology
|June 1, 2024
Summary
Diagnosing large granular lymphocytic leukemia (LGLL) is complex due to overlapping features. Accurate diagnosis requires integrating clinical, morphologic, immunophenotypic, clonal, and molecular findings to meet established criteria.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Large granular lymphocytic leukemia (LGLL) is a rare, indolent neoplasm of mature T or NK cells.
- Diagnosis can be challenging due to overlapping features with reactive conditions and other mimickers.
Purpose of the Study:
- To elucidate the differentiation of LGLL from its mimics.
- To highlight potential diagnostic pitfalls in LGLL diagnosis.
Main Methods:
- Presentation of two challenging LGLL cases.
- Comprehensive review of clinicopathologic features of LGLL.
Main Results:
- LGLL exhibits diverse clinical, morphological, immunophenotypic, and molecular profiles.
- These features overlap with reactive conditions and clonal disorders of uncertain significance.
Conclusions:
- Accurate LGLL diagnosis necessitates a multifaceted approach.
- Integration of clinical, morphologic, immunophenotypic, clonal, and molecular data is crucial.
- Adherence to major and minor diagnostic criteria ensures accurate LGLL identification.
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