Aberrant CD3 Expression in Mature B-Cell Chronic Lymphocytic Leukemia: An Observational Analytic Case Study on Lineage Promiscuity, Flow Cytometric Diagnostic Disambiguation, and Longitudinal Trajectory
DOI:
https://doi.org/10.37275/oaijmr.v6i6.954Keywords:
Aberrant CD3 antigen, Chronic lymphocytic leukemia, Flow cytometry immunophenotyping, Lineage promiscuity, Smudge cellsAbstract
Background: Aberrant CD3 expression in B-cell chronic lymphocytic leukemia (CLL) can complicate lineage assignment.
Objective: To describe the hematological trajectory, marrow findings, and flow cytometric evaluation of a patient reported to have CD3-positive B-cell CLL.
Methods: A 64-year-old woman with asthenia, constitutional symptoms, and hepatosplenomegaly underwent serial blood counts over 14 days, peripheral blood and marrow cytomorphological assessment, and multiparametric flow cytometry. Absolute and relative changes were calculated descriptively.
Results: Leukocyte counts increased from 58.63 to 65.29 × 10³/µL (+11.36%), with lymphocyte fractions of 83.4% and 88.7%. Hemoglobin decreased from 9.8 to 9.3 g/dL; platelet counts increased from 111 to 140 × 10³/µL. Peripheral blood showed mature lymphocytes and smudge cells. Marrow assessment reported 88% mature lymphocytes and an M:E ratio of 3:1. Flow cytometry showed CD19, CD20, and CD79a positivity with dim surface CD3 (MFI 2,170) and cytoplasmic CD3 (MFI 1,983); CD34 and MPO were reported as negative.
Conclusion: The case illustrates the importance of interpreting aberrant CD3 expression within a composite morphological and immunophenotypic assessment. The reported diagnosis and differential exclusions require correlation with the complete diagnostic record.
Authors
- I Gusti Ngurah Bayu Paramartha1*
- I Made Sila Darmana2
- I Dewa Komang Agung Cahyadi2
- I Made Dwi Payana2
- 1Intern Physician, Department of Clinical Pathology, Sanjiwani General Hospital, Gianyar, Indonesia
- 2Staff Pathologist, Department of Clinical Pathology, Sanjiwani General Hospital, Gianyar, Indonesia
Corresponding author I Gusti Ngurah Bayu Paramartha — ignbayuparamartha@gmail.com
Downloads
Published
Issue
Section
License
Copyright (c) 2026 I Gusti Ngurah Bayu Paramartha, I Made Sila Darmana, I Dewa Komang Agung Cahyadi, I Made Dwi Payana
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain copyright in their articles and grant Open Access Indonesian Journal of Medical Reviews (OAIJMR) the non-exclusive right of first publication. Unless otherwise stated on an individual article, published work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0). Users may share and adapt the work for non-commercial purposes provided that appropriate attribution is given, changes are indicated, and adaptations are distributed under the same license. Copyright in the journal website, logo, layout, and other publisher-owned materials is separate from copyright in individual articles.
How to Cite
Article Metrics
Views and downloads recorded by this journal.
