Aggressive NK cell leukemia. Presentation of a case

Abstract

Aggressive natural killer (NK) cell leukemia, is a systemic neoplastic proliferation, usually associated with Epstein-Barr Virus and aggressive clinical course. The objective was characterize a case of aggressive NK cell leukemia and the usefulness of flow cytometry. A 29-year-old woman with a history of Systemic lupus erythematosus (SLE). One month before her admission, she started with abdominal pain predominantly in the epigastrium and left upper quadrant, received two pulses of methylprednisolone. Five days before admission he presented unquantified thermal rise so he went to the hospital, She was admitted to the emergency department of the Almanzor Aguinaga Asenjo Hospital in Chiclayo, Peru.  Reporting on admission appears to be in generally good condition (GGC), apparent normal nutritional status (NNS), apparent normal level of hydration (NH), ventilating spontaneously, oral cavity with lesions, presence of purpuric petechiae in anterior trunk and abdomen, rhythmic heart sounds, capillary filling <2”, tachypnea, supraclavicular pulls, decreased vesicular murmur in PCA bases, no rales, with oxygen support, depressible abdomen, not painful, positive borborygmi, hemogram with leukocytosis, anemia and severe thrombocytopenia, 36% of “immature cells”, 64 normoblasts per 100 leukocytes, hypochromia, anisocytosis, a reactive HBcAb. On the tenth day she had a diagnostic impression of SLE with severe hematologic involvement. On the twenty-fifth day, a flow cytometry was performed, finding an aggressive NK cell leukemia, adding sepsis with respiratory focus and progressive liver dysfunction, she died one month after admission. Aggressive NK cell leukemia is uncommon and of aggressive clinical course, the cellular origin of its normal counterpart is not precisely known, flow cytometry was useful to identify, characterize and quantify NK cells with aberrant antigen expression. (www.actabiomedica.it)