Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report

Background: T-cell large granular lymphocytic (T-LGL) leukemia is a rare, chronic, often indolent lymphoproliferative disorder of mature T cells (CD3+). Severe neutropenia and other cytopenias are common features in patients with T-LGL leukemia and may cause infections, thus representing a major cau...

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Main Authors: Ioanna-Eirini Arvanitidou, Nikolaos G. Nikitakis, Alexandra Sklavounou
Format: Article
Language:English
Published: Lithuanian University of Health Sciences, Faculty of Odontology 2011-06-01
Series:eJournal of Oral Maxillofacial Research
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Online Access:http://www.ejomr.org/JOMR/archives/2011/3/e4/v2n3e4ht.htm
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author Ioanna-Eirini Arvanitidou
Nikolaos G. Nikitakis
Alexandra Sklavounou
author_facet Ioanna-Eirini Arvanitidou
Nikolaos G. Nikitakis
Alexandra Sklavounou
author_sort Ioanna-Eirini Arvanitidou
collection DOAJ
description Background: T-cell large granular lymphocytic (T-LGL) leukemia is a rare, chronic, often indolent lymphoproliferative disorder of mature T cells (CD3+). Severe neutropenia and other cytopenias are common features in patients with T-LGL leukemia and may cause infections, thus representing a major cause of morbidity in this disease. Immunosuppressive therapy with low-dose regimes of methotrexate, cyclophosphamide, corticosteroids or cyclosporine A is the treatment of choice. Amongst the variety of T-LGL leukemia complications, oral manifestations such as ulcers have been rarely reported. The purpose of this paper is to report a case of T-cell large granular lymphocyte leukemia with oral manifestations and to discuss their pathogenesis and management.Methods: In the present case, a 65 year old female with a two-month history of diagnosed T-LGL leukemia presented with oral lesions, including ulcerations on the ventral tongue and soft palate as well as swollen, erythematous and ulcerated gingiva. The patient was under treatment with methotrexate, granulocyte colony-stimulating factor (G-CSF) and erythropoietin.Results: Considering patients’ medical history and clinical appearance of the lesions, a clinical diagnosis of a neutropenic ulcer of the tongue was established. The oral lesions resolved after treatment with antibiotics, topical steroids and antiseptics combined with improvement of the hematological condition. The pertinent literature related to T-LGL leukemia ethiopathology, diagnostics and treatment was discussed.Conclusions: Although rare, T-cell large granular lymphocytic leukemia should be included in the list of lymphoproliferative disorders, which may present with oral manifestations as a result of the disease and its treatment complications.
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spelling doaj-art-5d223b46099243f98ecef2fd6e0095f22025-08-20T03:33:03ZengLithuanian University of Health Sciences, Faculty of OdontologyeJournal of Oral Maxillofacial Research2029-283X2011-06-0123e4Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case ReportIoanna-Eirini ArvanitidouNikolaos G. NikitakisAlexandra SklavounouBackground: T-cell large granular lymphocytic (T-LGL) leukemia is a rare, chronic, often indolent lymphoproliferative disorder of mature T cells (CD3+). Severe neutropenia and other cytopenias are common features in patients with T-LGL leukemia and may cause infections, thus representing a major cause of morbidity in this disease. Immunosuppressive therapy with low-dose regimes of methotrexate, cyclophosphamide, corticosteroids or cyclosporine A is the treatment of choice. Amongst the variety of T-LGL leukemia complications, oral manifestations such as ulcers have been rarely reported. The purpose of this paper is to report a case of T-cell large granular lymphocyte leukemia with oral manifestations and to discuss their pathogenesis and management.Methods: In the present case, a 65 year old female with a two-month history of diagnosed T-LGL leukemia presented with oral lesions, including ulcerations on the ventral tongue and soft palate as well as swollen, erythematous and ulcerated gingiva. The patient was under treatment with methotrexate, granulocyte colony-stimulating factor (G-CSF) and erythropoietin.Results: Considering patients’ medical history and clinical appearance of the lesions, a clinical diagnosis of a neutropenic ulcer of the tongue was established. The oral lesions resolved after treatment with antibiotics, topical steroids and antiseptics combined with improvement of the hematological condition. The pertinent literature related to T-LGL leukemia ethiopathology, diagnostics and treatment was discussed.Conclusions: Although rare, T-cell large granular lymphocytic leukemia should be included in the list of lymphoproliferative disorders, which may present with oral manifestations as a result of the disease and its treatment complications.http://www.ejomr.org/JOMR/archives/2011/3/e4/v2n3e4ht.htmΤ-cell large granular lymphocytic leukemianeutropeniaoral ulceracute necrotizing ulcerative gingivitismethotrexate
spellingShingle Ioanna-Eirini Arvanitidou
Nikolaos G. Nikitakis
Alexandra Sklavounou
Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report
eJournal of Oral Maxillofacial Research
Τ-cell large granular lymphocytic leukemia
neutropenia
oral ulcer
acute necrotizing ulcerative gingivitis
methotrexate
title Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report
title_full Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report
title_fullStr Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report
title_full_unstemmed Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report
title_short Oral Manifestations of T-Cell Large Granular Lymphocytic Leukemia: a Case Report
title_sort oral manifestations of t cell large granular lymphocytic leukemia a case report
topic Τ-cell large granular lymphocytic leukemia
neutropenia
oral ulcer
acute necrotizing ulcerative gingivitis
methotrexate
url http://www.ejomr.org/JOMR/archives/2011/3/e4/v2n3e4ht.htm
work_keys_str_mv AT ioannaeiriniarvanitidou oralmanifestationsoftcelllargegranularlymphocyticleukemiaacasereport
AT nikolaosgnikitakis oralmanifestationsoftcelllargegranularlymphocyticleukemiaacasereport
AT alexandrasklavounou oralmanifestationsoftcelllargegranularlymphocyticleukemiaacasereport