Expansion of large granular lymphocytes (natural killer cells) with limited antigen expression (CD2+, CD3−, CD4−, CD8−, CD16+, NKH−1‐) in a human immunodeficiency virus‐positive homosexual man

Lymphoid neoplasms associated with acquired immune deficiency syndrome (AIDS) are mostly of B‐cell type and rarely of T‐cell origin. The authors report a case of a homosexual HIV antibody‐positive, HTLV‐1 antibody‐negative man who developed T‐lymphoproliferative disorder (TGLD) after he experienced a viral‐like illness. The lymphoproliferative disorder was characterized by increased peripheral blood large granular lymphocytes (LGL) with azurophilic granules (natural killer [NK] cells) which had limited antigen expression: CD2+, CD3−, CD4−, CD8−, CD16+, NKH−1−. The LGL failed to express T‐cell or T‐cell‐related antigens, with the exception of CD2. No functional or gene rearrangement studies were performed on the patient's lymphocytes. However, the results of immunophenotyping, including CD25, W26, and HLA‐DR, were suggestive of an inactive state, and the negative finding for CD3 antigen was consistent with unarranged gene T‐cell receptors. This is the first reported case of TGLD in an HIV antibody‐positive patient.