Hepatosplenic T-Cell Lymphoma: Case Report & Literature Review

Case Report

Ann Hematol Oncol. 2017; 4(9): 1170.

Hepatosplenic T-Cell Lymphoma: Case Report & Literature Review

Maryam Radi Alghaza* and Abdullah Al Rashed

Hematology Consultant, Department of Hematopathology, Regional Laboratory in Dammam (DRL), Saudi Arabia

*Corresponding author: Maryam Radi Alghaza, Department of Hematopathology, Regional Laboratory in Dammam (DRL), Saudi Arabia

Received: August 01, 2017; Accepted: September 05, 2017; Published: September 26, 2017


Acute myeloid leukemia with Megakaryoblastic and Basophilic differentiation and CML with concurrent Megakaryoblastic and Basophilic Blast crisis are very rare diseases with only few reported cases in the literature.

Diagnosis of this leukemia with two types of blasts of the same lineage can be very challenging and morphology alone is not sufficient especially when the morphology is not classical. Flowcytometry and cytogenetic studies are important to establish the diagnosis. Here we report a case of AML with megakaryoblastic & basophilic differentiation & Positive Philadelphia chromosome by FISH.

Keywords: Hepatosplenic T-Cell lymphoma; Acute myeloid leukemia; Basophilia; Chronic myelogenous leukemia


Basophilia is commonly associated with Chronic Myelogenous Leukemia, notably in the accelerated phase or during blast crisis. It is also associated with other Myelo proliferative neoplasms. However, its association with acute leukemia is very rare and is described in association with either Acute basophilic leukemia or in Acute Leukemias with a mixture of Blasts with an important participation of mature or Immature Basophilic cells, Like Acute Myeloid Leukemias (AMLs) with recurrent genetic abnormalities such as t(6;9)(p23;q34). Incidence of Ph positive AML appears to be very low, apparently constituting less than 1% of all newly diagnosed cases of AML [1,2] Generally, presence of Ph chromosome provides strong evidence for blast crisis arising in the background of CML [3]. The most recent published case of similar morphological combination but negative for ph chromosome was published by Sreedharanunni et al in 2016 [4].

Case Presentation

A 54-year-old Egyptian man, who presented with Anemia and lytic lesion as evident by x-ray, was referred to our institution for Flowcytometry.

Periperhal Blood shows WBC 1717 × / ul. Hb- 6.7g/dl and Platelets count 82,000/ul. Pancytopenia with infiltration by around 14% Blasts, which are large in size with high Nucleo cytoplasmic ratio, Nucleus is predominantly round to oval with 1-2 nucleoli and mild to moderate amount of basophilic cytoplasm. Many of them have vacuoles. About 2-4 Blasts were slightly smaller in size than others had dark basophilic cytoplasm and had cytoplasmic Blebs (Figure 1).

Citation:Alghaza MR and Al Rashed A. Hepatosplenic T-Cell Lymphoma: Case Report & Literature Review. Ann Hematol Oncol. 2017; 4(9): 1170. ISSN:2375-7965