Analysis on clinicopathological features of 5 cases of aggressive NK-cell leukemia

LIU Xia; HUANG Yongta; LUO Yu; GUO Wenwen; MO Xianglan

doi:10.3969/j.issn.1674-3806.2025.05.17

Abstract：Objective To analyze the clinicopathological features of 5 cases of aggressive natural killer(NK)-cell leukemia(ANKL).Methods The clinicopathological data of 5 patients with ANKL who were admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from October 2015 to July 2021 were retrospectively analyzed.Immunohistochemical staining was used to detect the expressions of cytoplasmic CD3,CD45RO,CD56 and granzyme B,and T-cell intracellular antigen-1(TIA-1),CD4,CD5,CD8,CD20,myeloperoxidase(MPO),E-cadherin and Ki-67.The expression of Epstein-Barr virus(EBV)-encoded small RNA(EBER)was detected by using in situ hybridization method.Results Among the 5 patients with ANKL,4 patients were male and 1 patient was female,aged 16-85 years.The patients presented with high fever(5/5),accompanied by hepatosplenomegaly(3/5),elevated lactate dehydrogenase(5/5),peripheral pancytopenia(5/5)and coagulation dysfunction(5/5).The results of bone marrow biopsy revealed that the tumor cells showed interstitial or patchy infiltration,with medium-sized cell volume and pleomorphic cells,and showed signs of apoptosis and mitosis in the tissue hematoxylin-eosin(HE)slices.The results of immunohistochemical staining showed that cytoplasmic CD3,CD45RO,CD56,granzyme B and TIA-1 were positive,while CD4,CD5,CD8,CD20,MPO and E-cadherin were negative.The Ki-67 proliferation index was approximately 80％.The detection results of in situ hybridization showed that the tumor cells were EBER positive.One patient underwent chemotherapy and survived for 3 months.Four patients gave up treatment and had a survival period of 1-3 months.Conclusion ANKL is a rare systemic NK cell tumor,which is closely related to EBV infection.The disease progresses rapidly and needs to be differentiated from other mature T-and NK-cell lymphomas/leukemia.