Prolonged lymphocytosis as the first manifestation of Hodgkin-like adult T-cell leukemia/lymphoma

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• 作者：Achilé ; a L. Bittencourt^a ; ^{achilea@uol.com.br} ; Agnes Carvalho Andrade^a ; Cristiane Requiã ; o^b ; Maria da Gloria Bomfim Arruda^b ; Iguaracyra Ara&uacute ; jo^a
• 关键词：Adult T-cell leukemia/lymphoma ; HTLV-1 infection ; Pulmonary tuberculosis ; Hodgkin-like ATLL
• 刊名：The Brazilian Journal of Infectious Diseases
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：21
• 期：1
• 页码：119-122
• 全文大小：1377 K
• 卷排序：21

文摘

Hodgkin-like ATLL is a rare variant of adult T-cell leukemia/lymphoma (ATLL), a disease caused by human T-cell lymphotropic virus type-1 (HTLV-1). At admission, a 46-year-old female presented with lymphadenomegaly, lymphocytosis, slight elevation of LDH blood level, and acid-alcohol resistant bacilli in sputum and was being treated for pulmonary tuberculosis (Tb). She had lymphocytosis in the previous 20 months. Serology for HTLV-1 was positive. Lymph node was infiltrated by medium-sized lymphocytes with scattered Hodgkin and Reed-Sternberg-like cells CD30+, CS1-4+, and CD79a+. Background cells were CD4+ and CD25+. A clinical diagnosis of favorable chronic ATLL was given. She was treated with chemotherapy but later progressed to acute ATLL and ultimately died. Hodgkin-like ATLL should be considered in the histological differential diagnosis with Hodgkin lymphoma since treatment and prognosis of these diseases are distinct. It is also important to search for HTLV-1 infection in patients with unexplained prolonged lymphocytosis.