J Korean Med Sci.  2002 Dec;17(6):833-839. 10.3346/jkms.2002.17.6.833.

CD4+CD56+CD68+Hematopoietic Tumor of Probable Plasmacytoid Monocyte Derivation with Weak Expression of Cytoplasmic CD3

• Ko YH
• Kim SH
• Park KC
• Ree HJ

• KMID: 648798
• DOI: http://doi.org/10.3346/jkms.2002.17.6.833

Abstract

Hematopoietic neoplasm coexpressing CD4 and CD56 includes a subset of acute myeloid leukemia with myelomonocytic differentiation, plasmacytoid monocyte tumor, and other immature hematopoietic neoplasms of undefined origin. Herein, we report a CD4+CD56+CD68+ hematopoietic tumor that was thought to be a tumor of plasmacytoid monocytes. This case is unique in the absence of accompanying myelomonocytic leukemia and the faint expression of cCD3 on the tumor cells. The patient was a 22-yr old man presented with multiple lymphadenopathy and an involvement of the bone marrow. Tumor cells were large and monomorphic with an angulated eosinophilic cytoplasm of moderate amount. Nuclei of most tumor cells were eccentric and round with one or two prominent nucleoli. Rough endoplasmic reticulum was prominent in electron microscopic examination. Tumor cells expressed CD4, CD7, CD10, CD45RB, CD56, CD68, and HLA-DR and were negative for CD1a, CD2, sCD3, CD5, CD13, CD14, CD20, CD33, CD34, CD43, CD45RA, TIA-1, S-100, and TdT. cCD3 was not detected in the immunostaining using paraffin tissue, but was faintly expressed in flow cytometry and immunostaining using a touch imprint slide. T-cell receptor gene rearrangement analysis and EBV in situ hybridization showed negative results. Cytochemically, myeloperoxidase, Sudan black B, and alpha naphthyl butyrate esterase were all negative.

Keyword

Plasmacytoid Monocytes; Antigens; CD56; CD3

MeSH Terms

Adult
Antigens, CD/*biosynthesis
Antigens, CD3/*biosynthesis
Antigens, CD4/*biosynthesis
Antigens, CD45/biosynthesis
Antigens, CD56/*biosynthesis
Antigens, Differentiation, Myelomonocytic/*biosynthesis
Bone Marrow Cells/pathology
Cell Nucleus/pathology
Eosinophils/metabolism
Flow Cytometry
Gene Rearrangement
Humans
Immunohistochemistry
In Situ Hybridization
Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis/*metabolism
Lymph Nodes/pathology
Male
Microscopy, Electron
Monocytes/*metabolism
Receptors, Antigen, T-Cell/metabolism