Chronic active Epstein-Barr virus infection with progression to large granular lymphocytic leukemia

摘要

Dear Editor,A 34-year-old woman presented with 1-year history of recurrent vesicles, papules and erosions on her face (Fig. 1). Skin biopsy showed diffuse infiltration of lymphocytes and plasma cells with epidermal necrosis (Fig. 2a,b). Hypersensitivity to mosquito bites was not observed. We first diagnosed severe hydroa vacciniforme in an adult and performed further examination. Laboratory examination showed leukocytosis (white blood cell [WBC], 23 000L) with 20% granular lymphocytes. Flow cytometric analysis of peripheral blood mononuclear cells showed abnormal increment of CD3+ CD8+ cells (CD3+ 88.6%, CD3+CD4+ 36.1%, CD3+CD8+ 44.1%) which were considered as increased large granular lymphocytes (LGL) in laboratory examination. The immunophenotype of LGL was CD3+CD8+CD16-CD56-.