演題詳細

一般口演 / Oral Session

一般口演 99 (Oral Session 99) :ATL:臨床・病理

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日程
2013年10月13日(日)
時間
16:00 - 17:00
会場
第7会場 / Room No.7 (ロイトン札幌 2F リージェント)
座長・司会
宇都宮 與 (Atae Utsunomiya):1
1:今村病院分院 血液内科
 
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Hodgkin lymphoma-like Adult T-cell leukemia/lymphoma: Report of 7 cases

演題番号 : OS-3-142

新野 大介 (Daisuke Niino):1、前田 宏一 (Koichi Maeda):2、加藤 丈晴 (Takeharu Kato):3、崔 日承 (Ilseung Choi):4、宮下 要 (Kaname Miyashita):5、南里 知子 (Tomoko Nanri):6、吉田 真一郎 (Shinichiro Yoshida):7

1:Pathology, Kurume University, Japan、2:Hematology, Miyakonojo Hospital、3:Hematology, Goto Chuo Hospital、4:Hematology, Kyushu Cancer Center、5:Hematology, Saiseikai Fukuoka Hospital、6:Hematology, Amakusa Chuo Hospital、7:Hematology, Nagasaki Medical Center

 

Adult T-cell leukemia/lymphoma (ATLL) is a Human T-lymphotropic virus type-1 (HTLV-1) associated T-cell malignancy. We had described the rare morphologic variant of ATLL, Hodgkin-like ATLL. In this clinicopathological study, we analyzed 7 patients with this disease. In all cases serum-test results were positive for HTLV-1 and proviral HTLV-1 DNA bands have been found, although the bands are weaker than those usually seen in typical ATLL. The median age of patients was 60 (range 40-69) and male to female was 2 to 5. Laboratory data showed an elevation of LDH in 6 cases. Ann Arbor stage was I/II/III/IV in 1/0/1/5 patients. Six patients received chemotherapy, one received chemotherapy with stem cell transplantation, and the other was not treated. One patient died within 21 months, and six were still alive. Histologically, the lymph nodes exhibit a relatively preserved nodal architecture with diffuse infiltration of small-sized lymphocytes. Small aggregated foci or clusters of a few giant cells with irregularly lobulated nuclei are scattered throughout the expanded paracortex. In the immunohistological analysis the giant cells were positive for CD30, CD15, PAX5 and negative for CD20, CD3, TIA-1, CCR4, and the proliferating small lymphocytes were mainly positive CD3, CD4, CCR4 and negative CD8 in all cases. All cases were positive for EBV-ISH in nuclei of the giant cells. All patients showed indolent clinical course and relatively good survival. Pathologists and hematologists in HTLV-1 endemic area should be more aware of ATLL and understand this morphologic variant.

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