LARGE GRANULAR LYMPHOCYTE LEUKEMIA ASSOCIATED WITH HEPATOCELLULAR-CARCINOMA - A CASE-REPORT

The association of large granular lymphocyte leukemia (LGL-L) with hep atocellular carcinoma in a 55-year-old patient is described. An increa sed number of LGL was seen on peripheral blood smears. The immunopheno type was CD3(+), CD4(-), CD8(+), and a study of the TCR gene rearrange ment indicated the monoclonal nature of the proliferation. A liver mas s was detected on CT scan and an ultrasound-guided fine needle biopsy revealed the presence of hepatocholangiocellular elements. A right hep atectomy was performed. Major neutropenia persisted despite corticoste roids and granulocyte colony-stimulating growth factor (G-CSF) therapy . Methotrexate at 20 mg/week failed to control lymphocytosis after thr ee months of treatment. A new nodule of hepatocarcinoma reappeared twe lve months after surgery and a liver resection was performed.