Extremely high levels of natural killer cells in angioimmunoblastic lymphadenopathy.

Analysis of peripheral blood leukocytes from a patient with angioimmunoblastic lymphadenopathy using monoclonal antibodies and the fluorescence-activated cell sorter showed an unusually high proportion of cells that were OKT10+OKM1+63D3-. Since a large proportion of the large granular lymphocytes associated with natural killing in humans bears this surface phenotype, both blood and lymph node cells were subsequently tested for cell-mediated cytotoxicity in natural killer (NK)-cell assays. Following chemotherapy, both cells bearing the NK surface phenotype and the NK cytotoxicity disappeared and a population of cells, bearing none of the typical lymphocyte or monocyte markers, became dominant. At this point the patient was diagnosed as having immunoblastic sarcoma and shortly thereafter succumbed to his disease. In the few cases where extremely high levels of NK activity have been reported, the tumor cells themselves have been responsible for cell-mediated cytotoxicity. In this case, the final tumor population had no NK activity. Thus either a subpopulation of cytotoxic tumor cells was destroyed by chemotherapy or the patient had expanded numbers of NK cells reacting against his tumor prior to therapy.