How would you treat a patient with hemophagocytic lymphohistiocytosis and conflicting pathology reports one of which suggests PTCL-NOS and the other LGL?

Topics: Hematologic Malignancies • Medical Oncology • NCI-CCC Tumor Board Question • Hematology • HLH • T-Cell Lymphoma • UC Irvine • NCI-CCC Lymphoma Tumor Board Question

Hypercellular bone marrow with a CD8+ T cell infiltrate (TCR rearrangement equivocal). Numerous path reviews and conflicting results - LGL and PTCL-NOS both reported. No other secondary reason for HLH, no lymphadenopathy. Would you treat for LGL? PTCL? HLH-94 or 2004? Presenting symptoms (cytopenias and fevers) very responsive to steroids.

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