J Korean Med Sci.  1994 Dec;9(6):458-465. 10.3346/jkms.1994.9.6.458.

Adult T-cell leukemia/lymphoma in a Korean: a case report

• Lee SS
• Hong SI
• Lee DS
• Kang YK
• Kim CW
• Jang JJ

• KMID: 644836
• DOI: http://doi.org/10.3346/jkms.1994.9.6.458

Abstract

The clinicopathologic features of a Korean patient with adult T-cell leukemia/lymphoma(ATLL) are presented. A 51-year-old man, who has lived in Korea since birth, had multiple cutaneous nodules and multiple lymphadenopathy for the previous two months. A histopathologic study of the lymph node and skin lesion revealed T-cell non-Hodgkin's lymphoma of pleomorphic type, medium and large cell type. Peripheral blood examination showed leukemic features with 30% of abnormal lymphoid cells. HTLV-I proviral DNA pX region was detected in the DNA from peripheral blood mononuclear cells(PBMC) and the specific gag, pol, and env HTLV-I sequences were detected in the lymph node using polymerase chain reaction technique. Human T-cell leukemia/lymphoma type I(HTLV-I) antibodies were present in the serum. An immunophenotypic study of the lymph node revealed CD4 positive and CD8 negative helper/inducer T cell type surface markers. This case is the acute type, i.e. prototypic ATLL. He was treated with an intensive chemotherapy including cyclophosphamide, etoposide, doxorubicin, vincristine, and prednisone. Despite initial transient improvement, the tumor progressed after three cycles of the regimen and became refractory to further chemotherapy. These clinicopathologic findings, including the immunophenotypic analysis, established with certainty the diagnosis of HTLV-I-induced adult T-cell leukemia/lymphoma.

Keyword

Adult T-cell Leukemia/Lymphoma; Human T-cell Lymphotropic Virus Type I (HTLV-I); Lymph node; PCR

MeSH Terms

Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Case Report
Cyclophosphamide/administration & dosage
DNA, Viral/blood
Doxorubicin/administration & dosage
Etoposide/administration & dosage
Human
Human T-lymphotropic virus 1/isolation & purification
Immunophenotyping
Korea/epidemiology
Leukemia-Lymphoma, T-Cell, Acute, HTLV-I-Associated/drug therapy/epidemiology/pathology/virology
Lymph Nodes/pathology
Male
Middle Age
Prednisone/administration & dosage
Proviruses/isolation & purification
Tumor Stem Cells/chemistry/pathology
Vincristine/administration & dosage