e-ISSN: 2147-2181
CausaPedia - Hakemli Olgu Dergisi
e-ISSN: 2147-2181
CausaPedia - Hakemli Olgu Dergisi

Chronic Lymphocytic Leukemia With Meningeal Infiltration By Monoclonal T Lymphocytes

Submitted : 15.07.2014 Accepted : 04.09.2014 Published: 17.09.2014

Abstract

Chronic lymphocytic leukemia (CLL) is characterized by the proliferation and accumulation of monoclonal B lymphocytes. Leptomeningeal involvement is a rare complication and usually seen in T-cell leukemias. Here, we report a 70-year-old man with CLL and leptomeningeal infiltration by predominantly monoclonal T lymphocytes. Neurological symptoms were the first manifestations of the disease. Magnetic resonance imaging of the brain was normal. The diagnosis of T-cell leukemic meningitis was made by cytological and flow cytometry analysis of cerebrospinal fluid. The patient treated with both systemic and intrathecal chemotherapy. However, he died because of neutropenic fever. We think that this rare case of CLL was biclonal with peripheral B-cells, but meningeal T-cells.
Keywords: Chronic lymphocytic leukemia , Leptomeningeal involvement , Biclonal

Özet

Kronik lenfositik lösemi (KLL) monoklonal B lenfositlerin proliferasyonu ve birikimi ile karakterizedir. Leptomeningeal tutulum, nadir bir komplikasyonudur ve sıklıkla T-hücreli lösemilerde görülür. Burada, baskın olarak monoklonal T lenfositlerce leptomeningeal infiltrasyonun olduğu 70 yaşındaki KLL?li bir erkek hastayı sunmaktayız. Nörolojik bulgular,hastalığın ilk belirtileri oldu. Beynin manyetik rezonans görüntülemesi normaldi. T-hücreli lösemik menenjit tanısı, serebrospinal sıvının sitolojik ve akım sitometrik incelemesi ile konuldu. Hasta hem sistemik, hem de intratekal kemoterapi ile tedavi edildi. Bununla beraber, nötropenik ateş nedeniyle öldü. Bu nadir KLL vakasının, periferal B hücreler, fakat meningeal T hücrelerle birlikte biklonal olduğunu düşünmekteyiz.
Anahtar kelimeler: Kronik lenfositik lösemi , Leptomeningeal tutulum , Biklonal

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