COINCIDENTALLY DIAGNOSED LARGE GRANULAR CELL LEUKAEMIA IN A PATIENT WITH IDIOPATHIC DILATED CARDIOMYOPATHY

An 18-year old male patient was admitted to emergency room because of syncope. He has been diagnosed as having ventricular fibrillation and responded to immediate defibrillation and cardio-pulmonary resuscitation. Evaluation by echocardiography revealed idiopathic dilated cardiomyopathy. An automatic cardioverter defibrillator was implanted and antiarythmic medication was given by oral route. He was readmitted because of automatic defibrillator has given shock. This time physical examination revealed bilateral axillary lymphadenopathy and splenomegaly. A mild neutropenia and lymphocytosis was found to be in routine complete blood count examination. Large lymphocytes with cytoplasmic azurophilic granules were seen in blood smear, which accounted %30-35 of bone marrow nucleated cells. Immunophenotypic analysis of peripheral blood showed that the lymphocytosis is consistent with T cell large granular cell leukaemia. Because he was asymptomatic and not severely neutropenic, follow up was without any treatment.

Keywords: large granular lymphocyte, leukaemia, cardiomyopathy