Korean J Dermatol.  2007 Jan;45(1):58-62.

A Case of Adult T-cell Leukemia/Lymphoma

• Jung JY
• Lee HJ
• Lee JH
• Lee KH

Abstract

Adult T-cell leukemia/lymphoma (ATLL) is a human malignancy associated with human T-cell leukemia virus type I (HTLV-I), which frequently involves the skin. ATLL can be diagnosed based on clinicopathological findings and the presence of anti-HTLV-I serum antibodies and monoclonal integrated HTLV-I provirus in the DNA of tumor cells. It is characterized by leukemia, lymphadenopathy, hypercalcemia, and lytic bone lesions. We report a case of ATLL in a 59-year-old man who developed multiple, scattered papules on the face and trunk. He had a 3-month history of melena. The physical examination showed multiple cervical and axillary lymph node enlargements. On laboratory investigation, the white blood cell count was 113,900/mm(3) with 70% atypical lymphocytes. Histopathological and immunohistochemical analyses of a skin and stomach biopsy confirmed the diagnosis of T-cell lymphoma. Final diagnosis of ATLL was made based on HTLV-I positivity. The patient underwent multiple cycles of combination chemotherapy and combination therapy of zidovudine and interferon-alpha which produced some improvement, but he died of pulmonary complications 3 months after the initial diagnosis.

Keyword

Adult T-cell leukemia/lymphoma; HTLV-I

MeSH Terms

Adult*
Antibodies
Biopsy
Diagnosis
DNA
Drug Therapy, Combination
Human T-lymphotropic virus 1
Humans
Hypercalcemia
Interferon-alpha
Leukemia
Leukemia, T-Cell
Leukemia-Lymphoma, Adult T-Cell
Leukocyte Count
Lymph Nodes
Lymphatic Diseases
Lymphocytes
Lymphoma, T-Cell
Melena
Middle Aged
Physical Examination
Proviruses
Skin
Stomach
T-Lymphocytes*
Zidovudine
Antibodies
DNA
Interferon-alpha
Zidovudine