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Transient monoclonal expansion of CD8+/CD57+ T‐cell large granular lymphocytes after primary cytomegalovirus infection

Lymphocytosis associated with viral infection is generally polyclonal or oligoclonal. In this article, we describe a case of transient monoclonal CD8+/CD57+ T‐cell lymphocytosis with large granular lymphocyte (LGL) morphology occurring after primary CMV infection and review cases of virus‐associated monoclonal CD8+ T‐cell expansions reported in the literature. Several clinical features shared by virus‐associated monoclonal CD8+ T‐cell expansions suggest the reactive nature of the lymphocytosis. Based on this, our case report and those reported in the literature support the notion that T‐cell receptor clonality per se is not necessarily indicative of malignancy. These observations further corroborate the need for a close follow‐up before assigning the diagnosis of LGL leukemia to individuals developing monoclonal CD8+ T‐cell expansions. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.