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[Transient large granular lymphocytosis associated with pulmonary tuberculosis: a case report]

A Otsuji1, N Otsuji, T Ohno

  • 1Second Department of Internal Medicine, Mie University School of Medicine.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|December 1, 1990
PubMed

Insights

A 61-year-old woman experienced large granular lymphocytosis linked to pulmonary tuberculosis. Treatment for tuberculosis resolved the hematological abnormality, suggesting a reactive condition.

Area of Science:

  • Hematology
  • Immunology
  • Infectious Diseases

Background:

  • Large granular lymphocytosis (LGL) is a rare hematological condition.
  • Natural Killer (NK) cell LGL can be associated with various conditions, including autoimmune disorders and infections.

Observation:

  • A 61-year-old woman presented with fever, anemia, and splenomegaly.
  • Immunophenotyping revealed CD2+, CD3-, CD16+, CD57+ NK cells with cytotoxic activity.
  • Pulmonary tuberculosis was diagnosed four months after admission.

Findings:

  • The patient exhibited reactive NK cell large granular lymphocytosis.
  • Treatment of pulmonary tuberculosis led to the resolution of pancytopenia and LGL.
  • Molecular analysis confirmed germline configuration of T cell receptor beta chain genes, ruling out a lymphoid malignancy.

Implications:

  • This case highlights a potential association between pulmonary tuberculosis and reactive NK cell LGL.
  • Effective anti-tuberculosis therapy can lead to hematological remission in such cases.
  • It underscores the importance of investigating underlying infections in patients with unexplained LGL.

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