Advertisement

International Journal of Hematology

, Volume 97, Issue 5, pp 667–672 | Cite as

Development of peripheral T-cell lymphoma not otherwise specified in an HTLV-1 carrier

  • Tomohiro IshigakiEmail author
  • Masamichi Isobe
  • Seiichiro Kobayashi
  • Koichiro Yuji
  • Nobuhiro Ohno
  • Nobukazu Watanabe
  • Arinobu Tojo
  • Kaoru Uchimaru
Case Report

Abstract

Human T-cell leukemia virus type 1 (HTLV-1) causes adult T-cell leukemia (ATL) after a long latency period of about 60 years. As the mature T-cell neoplasms that emerge in patients infected with HTLV-1 are often ATL, T-cell neoplasms developing in such patients tend to be diagnosed simply as ATL without further investigation. However, not all T-cell neoplasms that develop in HTLV-1-infected cases are ATL. Mature T-cell malignancies other than ATL should be carefully excluded in patients infected with HTLV-1, as these sometimes closely resemble ATL in their clinical, morphological, and histological features. Here, we present a case of peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) in an HTLV-1 carrier. Confirmation of monoclonal integration of the virus with Southern blotting leads to a definite diagnosis of ATL. Although we did not detect the monoclonal integration band of HTLV-1 in this case, the high HTLV-1 proviral load complicated the diagnosis. Multicolor flow cytometric analysis clearly showed that HTLV-1 was not integrated in the tumor cells, and facilitated discrimination of PTCL-NOS from ATL.

Keywords

Human T-cell leukemia virus type 1 (HTLV-1) Adult T-cell leukemia (ATL) Multicolor flow cytometry Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) 

Notes

Conflict of interest

The authors declare no conflicts of interest.

References

  1. 1.
    Matsumoto M, Nomura K. Clinical and hematological features of adult T cell leukemia in southern part of Kyushu, Japan (author’s transl). Rinsho Ketsueki. 1979;20:1040–7.PubMedGoogle Scholar
  2. 2.
    Yoshida M, Miyoshi I, Hinuma Y. Isolation and characterization of retrovirus from cell lines of human adult T-cell leukemia and its implication in the disease. Proc Natl Acad Sci USA. 1982;79:2031–5.PubMedCrossRefGoogle Scholar
  3. 3.
    Shimoyama M. Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma. A report from the Lymphoma Study Group (1984–87). Br J Haematol. 1991;79:428–37.PubMedCrossRefGoogle Scholar
  4. 4.
    Ishitsuka K, Tamura K. Treatment of adult T-cell leukemia/lymphoma: past, present, and future. Eur J Haematol. 2008;80:185–96.PubMedCrossRefGoogle Scholar
  5. 5.
    Nakano-Akamatsu S, Takahashi R, Sekioka Y, et al. CD20- and CD56-positive T-cell large granular lymphocyte leukemia in a human T-cell leukemia virus type 1 carrier. Int J Hematol. 2007;86:348–51.PubMedCrossRefGoogle Scholar
  6. 6.
    Ohmatsu H, Sugaya M, Fujita H, et al. Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma in a human T-cell leukaemia virus type-1 carrier. Acta Derm Venereol. 2010;90:324–5.PubMedGoogle Scholar
  7. 7.
    Chuang SS, Ichinohasama R, Chu JS, et al. Differential diagnosis of angioimmunoblastic T-cell lymphoma with seropositivity for anti-HTLV antibody from adult T-cell leukemia/lymphoma. Int J Hematol. 2010;91:687–91.PubMedCrossRefGoogle Scholar
  8. 8.
    Iwanaga M, Watanabe T, Utsunomiya A, et al. Human T-cell leukemia virus type I (HTLV-1) proviral load and disease progression in asymptomatic HTLV-1 carriers: a nationwide prospective study in Japan. Blood. 2010;116:1211–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Ohshima K. Pathological features of diseases associated with human T-cell leukemia virus type I. Cancer Sci. 2007;98:772–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Kamihira S, Atogami S, Sohda H, et al. Significance of soluble interleukin-2 receptor levels for evaluation of the progression of adult T-cell leukemia. Cancer. 1994;73:2753–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Tian Y, Kobayashi S, Ohno N, et al. Leukemic T cells are specifically enriched in a unique CD3(dim) CD7(low) subpopulation of CD4(+) T cells in acute-type adult T-cell leukemia. Cancer Sci. 2011;102:569–77.PubMedCrossRefGoogle Scholar
  12. 12.
    Kobayashi S, Tian Y, Ohno N, et al. The CD3 versus CD7 plot in multicolor flow cytometry reflects progression of disease stage in patients infected with HTLV-I. PLoS ONE. 2013;8:e53728.PubMedCrossRefGoogle Scholar
  13. 13.
    Asou N, Kumagai T, Uekihara S, et al. HTLV-I seroprevalence in patients with malignancy. Cancer. 1986;58:903–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Kozuru M, Uike N, Muta K, et al. High occurrence of primary malignant neoplasms in patients with adult T-cell leukemia/lymphoma, their siblings, and their mothers. Cancer. 1996;78:1119–24.PubMedCrossRefGoogle Scholar
  15. 15.
    Suefuji H, Ohshima K, Hayabuchi N, et al. HTLV-1 carriers with B-cell lymphoma of localized stage head and neck: prognosis, clinical and immunopathological features. Br J Haematol. 2003;123:606–12.PubMedCrossRefGoogle Scholar
  16. 16.
    Sugata K, Satou Y, Yasunaga JI, et al. HTLV-1 bZIP factor impairs cell-mediated immunity by suppressing production of Th1 cytokines. Blood. 2012;119(2):434–44.Google Scholar
  17. 17.
    Imaizumi Y, Tsukasaki K, Tsushima H, et al. Lymphoma cases without detectable monoclonal HTLV-1 integration in HTLV-1 carrier. Rinsho Ketsueki. 2012;53:1359.Google Scholar
  18. 18.
    Lotan I, Khlebtovsky A, Inbar E, et al. Primary brain T-cell lymphoma in an HTLV-1 serologically positive male. J Neurol Sci. 2012;314:163–5.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2013

Authors and Affiliations

  • Tomohiro Ishigaki
    • 1
    • 2
    Email author
  • Masamichi Isobe
    • 1
  • Seiichiro Kobayashi
    • 3
  • Koichiro Yuji
    • 1
  • Nobuhiro Ohno
    • 1
  • Nobukazu Watanabe
    • 2
  • Arinobu Tojo
    • 1
    • 3
  • Kaoru Uchimaru
    • 1
  1. 1.Department of Hematology and Oncology, Research Hospital, The Institute of Medical ScienceThe University of TokyoTokyoJapan
  2. 2.Laboratory of Diagnostic Medicine, Division of Stem Cell Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
  3. 3.Division of Molecular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan

Personalised recommendations