Presentation
We present an unusual case of human T-cell leukemia-lymphoma virus type 1 (HTLV-1)-associated adult T-cell leukemia/lymphoma in an human immunodeficiency virus (HIV) patient who presented with non-diffuse, papular, waxing and waning cutaneous eruptions [ncbi.nlm.nih.gov]
Entire Body System
-
Lymphadenopathy
The patient was a 74-year-old Japanese woman with rheumatoid arthritis (RA) who developed generalized lymphadenopathy with elevated levels of lactase dehydrogenase (LD), and soluble IL-2 receptor (sIL-2R). [ncbi.nlm.nih.gov]
Hypercalcemia from increased osteoclast bone resorption • 4 clinical subtypes of ATLL Acute subtype – Most common subtype, 60%, often in children – Severe peripheral blood lymphocytosis, WBC, lactate dehydrogenase (LDH), skin lesions, lymphadenopathy [basicmedicalkey.com]
-
Fatigue
In acute ATLL, symptoms develop rapidly and include fatigue, skin rash and enlarged lymph nodes in the neck, armpit and groin. [leukaemia.org.au]
[…] person-years. 1 This virus causes adult T-cell leukemia–lymphoma. 2 We report a case of adult T-cell leukemia–lymphoma during pregnancy.A 23-year-old woman was admitted to a hospital in South Carolina because of a 7-day history of sore throat, fever, and fatigue [nejm.org]
Epidemiology endemic regions Japan Caribbean sub-Saharan Africa Middle East Central and South America Characteristic finding is “flower” cell on peripheral blood smear Presentation Symptoms hypercalcemia constipation altered mental status kidney stone weakness fatigue [medbullets.com]
Other symptoms can include night sweats, fatigue, fever, and a condition called pruritis (a feeling of the persistent need to scratch). [knowcancer.com]
It is most commonly used in combination with chemotherapy The radiation may be administered by a machine placed outside the body, or by placing a radioactive material inside the body The side effects of radiation therapy include nausea, vomiting, fatigue [dovemed.com]
Immune System
-
Splenomegaly
Splenomegaly was also observed. A bone marrow biopsy revealed normal trabecular bone, 65% of total marrow cellularity in separate marrow spaces, myeloid hyperplasia and severe eosinophilia. [ncbi.nlm.nih.gov]
Physical examination and imaging studies show massive splenomegaly with no lymphadenopathy. There was no hypercalcemia or increased in serum LDH. [pathologyoutlines.com]
The acute type shows a rapidly progressive clinical course and most of the characteristic features of ATL: leukemic manifestation, generalized lymphadenopathy, hepatomegaly, splenomegaly, skin involvement, hypercalcemia, and the infiltration of other [clinicalgate.com]
Respiratoric
-
Sputum
We suggest that sputum evaluation in patients with ATLL risk factors can be diagnostic. [ncbi.nlm.nih.gov]
The symptoms and signs include abdominal pain, diarrhea, ascites, jaundice, pleural effusion, cough, sputum, fever, and unconsciousness because of organ involvement, hypercalcemia, and/or opportunistic infections. 2. [clinicalgate.com]
Gastrointestinal
-
Abdominal Pain
The patient herein reported presented diffuse abdominal pain with duration of eight months in addition to ascites. The diagnosis of the acute leukemia type of ATL was done with base on clinical, laboratory and imaging findings. [ncbi.nlm.nih.gov]
Itching involving the skin (ATLL, Sezary syndrome) Feeling full quickly when eating or abdominal pain or fullness (T-PLL) If you are concerned about any changes you experience, please talk with your doctor. [cancer.net]
In March 1987, the patient returned to the hospital because of abdominal pain, nausea, vomiting, and somnolence. Laboratory studies revealed a leukocytosis with abnormal lymphocytes, a calcium level of 20.5 mg/dL, and an amylase level of 1,209 IU/L. [cdc.gov]
[…] rashes, abdominal pain, and a general feeling of illness If the brain is involved, then neurological symptoms such as the following may be observed: Confusion Tinnitus (ringing in the ears) Hearing and visual impairment If the gastrointestinal (GI) tract [dovemed.com]
The symptoms and signs include abdominal pain, diarrhea, ascites, jaundice, pleural effusion, cough, sputum, fever, and unconsciousness because of organ involvement, hypercalcemia, and/or opportunistic infections. 2. [clinicalgate.com]
Skin
-
Photosensitivity
Phototherapy was also initiated, but had to be discontinued due to the development of photosensitivity. Treatment with the combination of mogamulizumab and etoposide (25 mg/day for 21 days) was started in May 2014. [ncbi.nlm.nih.gov]
Eyes
-
Hemianopsia
[…] presented with a rare case of adult T-cell leukemia/lymphoma (ATL) occurring as only intracerebral mass lesion manifesting as progressively worsening headaches, transient mild weakness of the left lower extremity, bilateral papilledema, and left homonymous hemianopsia [ncbi.nlm.nih.gov]
-
Lacrimation
A 69-year-old Japanese male presented with a 3-month history of bilateral ptosis with lacrimal gland bulge. He came from western Japan, an area endemic for human T-lymphotropic virus Type 1 infection. [ncbi.nlm.nih.gov]
Neurologic
-
Altered Mental Status
mental status kidney stone weakness fatigue anorexia Physical exam hepatoseplenomegaly in 50% lymphadenopathy in almost all skin lesions variable morphology plaque, papule, nodulotumoral, erythroderma, and purpuric Evaluation Complete blood count 5% [medbullets.com]
-
Papilledema
A 48-year-old female presented with a rare case of adult T-cell leukemia/lymphoma (ATL) occurring as only intracerebral mass lesion manifesting as progressively worsening headaches, transient mild weakness of the left lower extremity, bilateral papilledema [ncbi.nlm.nih.gov]
Workup
Further workup revealed ATLL with an underlying HTLV infection. [ncbi.nlm.nih.gov]
[…] lymphocytes ( 5%) should be classified as smoldering ATL because recent data from the United Kingdom suggest that these patients have an excellent long-term survival, 51 contrary to smoldering ATL patients with skin or lung infiltration. 52 Diagnostic workup [bloodjournal.org]
Biopsy
-
Cytoplasmic Inclusion Bodies
Although ATL cells were not detected in the autopsied lungs and a variety of other tissues, cytoplasmic inclusion bodies, which are commonly observed in RNA viral infection, were abundantly observed in the autopsied lung tissue. [ncbi.nlm.nih.gov]
Treatment
Mogamulizumab (Moga), an antibody drug for CC chemokine receptor type 4, has been introduced for the treatment of ATL. [ncbi.nlm.nih.gov]
Prognosis
Improved understanding of the clinical factors predicting the prognosis after Moga may contribute to improved treatment strategies for ATL. [ncbi.nlm.nih.gov]
Etiology
Adult T-cell leukemia/lymphoma (ATLL) is a rare T-cell disorder that is etiologically linked to chronic infection with human T-cell lymphotropic virus type 1. ATLL is divided into four subtypes: acute, lymphomatous, chronic, and smoldering. [ncbi.nlm.nih.gov]
[…] leukemia/lymphoma in Israel: report of two patients of Romanian origin Haematologica January 2005 90: ECR13; doi: Abstract Human T-lymphotropic virus type 1 (HTLV-1) was the first human oncovirus isolated by Gallo et al. in 1980 and established as an etiological [haematologica.org]
TERMINOLOGY Abbreviations • Adult T-cell leukemia/lymphoma (ATLL) Definitions • T-cell lymphoma/leukemia of regulatory T cells [CD4( ), CD25( ), FOXP3( )] caused by human T-cell leukemia virus type I (HTLV-I) ETIOLOGY/PATHOGENESIS Infectious Agents • [basicmedicalkey.com]
Epidemiology
This review summarizes the epidemiology of malignant lymphoma and highlights novel studies on adult T-cell leukemia/lymphoma recently published in Japan. KEYWORDS: ATLL; Epidemiology; Japan [ncbi.nlm.nih.gov]
The epidemiological anamnesis and screening indicate that both patients acquired the HTLV-1 from their mothers leaving in Romania. [haematologica.org]
Toshiki Watanabe, Takuya Fukushima Springer, ٢٧/٠٤/٢٠١٧ - 169 من الصفحات This book provides essential information on the epidemiology, molecular and genetic features, anti-CCR4 antibody therapy and a nationwide study of transplantation on human T-leukemia [books.google.com]
Pathophysiology
Increasing research on malignant lymphoma has focused on its pathophysiology, diagnosis, and therapeutic treatment. [ncbi.nlm.nih.gov]
Pathophysiology HTLV-1 appears to be a necessary factor in the development of ATL. However, why a small percentage of carriers develop ATL when the majority never do is poorly understood. [psychiatryadvisor.com]
[…] plasma) Sites Widespread lymph node involvement in most Systemic: spleen and extranodal sites including the skin, lungs, liver, gastrointestinal tract and central nervous system Main extranodal sites: skin (involved in 50% of cases) and peripheral blood Pathophysiology [pathologyoutlines.com]
Pathophysiological study demonstrated that accumulated CD30 cells were shown among the T cells but not among B cells ( Figure 4 ). Figure 4: CD30 T cells in lung lesion of ATLL in the indolent phase. [omicsonline.org]
Prevention
and Complications Prognosis poor median survival time 6 months - 2 years Prevention to prevent mother to infant transmission cessation of breastfeeding in moms with known HTLV-1 avoid sexual contact with infected individuals Complications opportunistic [medbullets.com]
BACKGROUND AND PURPOSE: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive hematological malignancy caused by human T-cell leukemia virus type-1 (HTLV-1); no effective methods have yet been identified to prevent development of ATLL in carriers of [ncbi.nlm.nih.gov]
[…] of HTLV-I transmission prevents ATLL Only gold members can continue reading. [basicmedicalkey.com]
Based on recent evidence, the book presents new treatment methods for ATL and infection prevention of HTLV-1, enabling clinicians, researchers and post-docs specializing in hematology and virology to gain a valuable overview of the disease. [books.google.com]