Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 16, Number 5, May 2025, pages 181-186

High-Sensitivity Flow Cytometric Detection of a Small Circulating Population of Nodal T-Follicular Helper Cell Lymphoma Angioimmunoblastic Type Cells

Figures

↓  Figure 1. Peripheral blood smear showed plasmacytoid cells (blue arrow, approximately 5% of white cells) and red cell rouleaux (red arrow).
Figure 1.
↓  Figure 2. The MFC analysis included sequentially: CD45/side scatter, CD45+++/CD3+, and CD3+/CD10+, with further phenotypic characterization using CD4, CD5, CD7, and CD8. The analysis disclosed a small circulating population of atypical T cells (in red) expressing CD3+, CD10+, bimodal CD7+, and negativity for CD8, with strong positivity for CD5 and reduced expression of CD4, if compared to normal T CD4+ and CD8+ cell counterparts (in green). MFC: multiparametric flow cytometry.
Figure 2.
↓  Figure 3. nTFHL-AI cells (in red) were negative for TRBC1 JOVI-1, confirming the T-cell clonal restriction. The normal T CD4+ and CD8+ cell counterpart (in green) showed bimodal expression of TRBC1 JOVI-1, indicating polyclonality. nTFHL-AI: nodal T-follicular helper cell lymphoma angioimmunoblastic type; TRBC1: TCRβ-chain constant region 1.
Figure 3.
↓  Figure 4. (a) Small to medium-sized T CD4+ cells surrounding endothelial venules (red arrow) and a proliferation of follicular dendritic cells (blue arrow) were variably detected. (b) Accompanying polymorphic inflammatory cells and CD8+ granzyme+ T cells were observed. The atypical T-cell population expressed CD10+ (c), CD5+ (d), with partial expression of CD7 (e), and CD30 (f).
Figure 4.