Adult T cell leukemia/lymphoma with lymphopenia in a Korean.
10.3346/jkms.2000.15.2.233
- Author:
Ho Jong JEON
1
;
Mi Ja LEE
;
Yu Kyung JEONG
;
Dong Myung LEE
;
Yoon Kyung OH
;
Chul Woo KIM
Author Information
1. Department of Pathology, Chosun University Medical School, Kwangju, Korea. hijon@mail.chosun.ac.kr
- Publication Type:Case Report ; Research Support, Non-U.S. Gov't
- Keywords:
Leukemia/Lymphoma, Adult T-Cell;
HTLV-I;
Polymerase Chain Reaction;
Flow Cytometry;
Hypercalcemia
- MeSH:
Biopsy;
Bone Marrow/pathology;
Case Report;
DNA, Viral/analysis;
Fatal Outcome;
Female;
Flow Cytometry;
Gene Products, env/genetics;
Gene Products, pol/genetics;
Gene Products, tax/genetics;
HTLV-BLV Infections/pathology;
HTLV-I;
Human;
Hypercalcemia/virology;
Hypercalcemia/pathology;
Immunophenotyping;
Korea;
Leukemia, T-Cell/virology;
Leukemia, T-Cell/pathology*;
Leukemia, T-Cell/immunology;
Lymph Nodes/pathology;
Lymphopenia/virology;
Lymphopenia/pathology*;
Lymphopenia/immunology;
Microscopy, Electron;
Middle Age;
Support, Non-U.S. Gov't;
T-Lymphocytes/virology;
T-Lymphocytes/ultrastructure;
T-Lymphocytes/pathology
- From:Journal of Korean Medical Science
2000;15(2):233-239
- CountryRepublic of Korea
- Language:English
-
Abstract:
We experienced a case of adult T cell leukemia/lymphoma (ATLL) in a 48-year-old Korean female, who has never been abroad since birth and no history of blood transfusion. The patient had hypercalcemia and multiple lymphadenopathy. Histopathologic study of left cervical lymph node (LN) and bone marrow (BM) revealed that infiltrates of malignant lymphoid cells were composed of small, medium and large cells with pleomorphic nuclei. Smears of peripheral blood (PB) showed lymphopenia (16%) with the appearance of a few atypical lymphoid cells (less than 2%), but not the typical clover leaf cells seen in ATLL. Immunophenotypic study of LN and BM revealed T cell phenotype. PB showed increased CD4+ T cell (T(H), CD3/CD4+, 57%) and decreased CD8+ T cell counts (T(S), CD3/CD8+, 6.7%). The sera of the patient and her family were reactive for HTLV-I antibody. The specific sequences of pol, env, and tax of HTLV-I DNA were detected in the lymphoma cells and peripheral blood mononuclear cells (PBMC) using polymerase chain reaction. Ultrastructural examination of PBMC confirmed numerous type c virus particles in extracellular space. This case was an acute type of ATLL without overt leukemic features in PB. Despite chemotherapy and intensive conservative treatment, she died 3 months after admission.
