[Adult T-cell leukemia with vertebral bone tumor and acute transverse myelopathy].
We describe a case of adult T-cell leukemia (ATL) with vertebral bone invasion, who developed acute paraplegia and responded well to irradiation and combined chemotherapy. A 36-year-old man born in Tsushima Island was admitted to our hospital in May 1987, because of a sudden onset of paraplegia, hypesthesia below the level of 7th thoracic vertebra and vesicorectal disturbance. The white blood cell count was 9,500/microliter with 16% of abnormal lymphocytes showing lobulated nuclei. The surface marker analysis revealed that CD3, CD4, CD8 and CD25 positive cells were 88.1, 83.9, 6.4 and 1.3% of the peripheral mononuclear cells, respectively. Anti-ATLA antibody was positive. Serum calcium level was elevated. Bone scintigraphy showed multiple vertebral bone lesions. Vertebral bone mass and a compressed spinal cord in the 7th thoracic level were confirmed by CT scanning and MR imaging. Cerebral spinal fluid was negative for tumor cells. A diagnosis of ATL was made. Irradiation and combination chemotherapy improved bone lesions and neurological signs and the disease was well controlled by maintenance chemotherapy up to the present (August, 1988).
Kato
S
S
Yamamura
N
N
Sugimura
T
T
Sumii
T
T
Suematsu
E
E
Ideguchi
H
H
Nishimura
J
J
Nawata
H
H
D000208:Acute Disease; D000328:Adult; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications* / Q000473:pathology; D008297:Male; D009361:Neoplasm Invasiveness; D013118:Spinal Cord Diseases / Q000209:etiology*; D013125:Spinal Neoplasms / Q000150:complications* / Q000473:pathology; D013904:Thoracic Vertebrae