A biclonal large granular lymphocyte (LGL)/NK-associated (NKa) disorder of CD4+ and CD8+ lymphocyte subpopulations characterized by the simultaneous presence of distinct TCR rearrangements

Summary. This communication reports a patient with concomitant expansions of CD4⁺ and CD8⁺ large granular lymphocytes. Immunological analyses revealed that the abnomally increased CD4⁺ LGL fraction was phenotypically similar to other reported persistent CD4⁺ LGL expansions, whereas the phenotypic profile for the CD8⁺ LGL component was unusual. of particular note was the finding that both the CD4⁺ and CD8⁺ LGL fractions showed high membrane the CD45RO isoform expression, thus suggesting their 'primed' status. Molecular biology studies of immunomagnetically fractionated cells using a Tγ9 TCR gamma gene primer further revealed that the CD4⁺ and CD8⁺ components were both clonal but showed different patterns of rearrangement It is suggested that the simultaneous presence of CD4⁺ and CD8⁺ clonal populations are unlikely to have been derived from a common progenitor and that they reflect expansions of functionally restricted subpopulations