Abstract
Among atypical lymphocytes (AL) examined morphologically and immunohistochemically
in the cerebrospinal fluid (CSF) of adult patients with encephalitis, we distinguished
a CD4+ `type I' AL, with a multilobulated nucleus resembling those of the abnormal cells
in adult T-cell leukemia (ATL), from a CD8+ `type II' AL, a large lymphocyte with basophilic cytoplasm and a nucleus containing
coarse chromatin. Type I AL were detected in 7 of 8 patients with Japanese encephalitis
(JE), but in none of 11 patients with herpes simplex encephalitis (HSE) and none of
19 patients with unspecified acute viral encephalitis. Type II AL were seen frequently
in all three groups. The observation of type I AL in CSF strongly suggests JE, which
warrants careful follow-up without antiherpetic drugs. In identifying type I AL, which
presumably are virally transformed lymphocytes, care must be taken to distinguish
them from leukemic involvement by ATL cells, which frequently includes the meninges.
Both type I and type II AL also must be differentiated from lymphoma cells.
Keywords
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Article info
Publication history
Accepted:
June 30,
1998
Received in revised form:
June 25,
1998
Received:
April 14,
1998
Identification
Copyright
© 1998 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
