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Open Access Highly Accessed Case report

Persistence of Natural Killer (NK) cell lymphocytosis with hyposplenism without development of leukaemia

Sujoy Khan12 and K Myers1*

Author Affiliations

1 Department of Haematology, Prince Charles Hospital, Merthyr Tydfil, Wales, CF47 9DT UK

2 Department of Immunopathology, St. Bartholomew's Hospital, 51-53 Bartholomew's Close, West Smithfield, London, EC1A 7BE UK

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BMC Clinical Pathology 2005, 5:8  doi:10.1186/1472-6890-5-8

Published: 7 September 2005

Abstract

Background

Natural killer (NK) cell lymphocytosis usually has an indolent course and can progress into massive lymphocytosis with development of cytopenias and neoplastic diseases. NK-cells usually express one or more "NK-associated" antigens (CD16, CD56, CD57). Reactive expansions are seen in autoimmune diseases, viral infections, solid tumours and non-Hodgkin's lymphoma.

Case presentation

We report a lady with a benign clinical course over 10 years and persistent CD8+/CD3-/CD57+/CD16+ LGL proliferation with presence of Howell-Jolly bodies (functional hyposplenism), an association not previously described.

Conclusion

We discuss the possible causes of clonal expansion and conclude that this may be part of the spectrum of immune dysregulation associated with NK-cell lymphocytosis.