Human T-lymphotropic virus type I DNA in spinal cord of tropical spastic paraparesis with concomitant human T-lymphotropic virus type I-negative Hodgkin's disease.
We studied a 58-year-old black woman from Barbados who simultaneously developed myelopathy and lymphoma with human T-lymphotropic virus type I (HTLV-I) antibodies in serum and cerebrospinal fluid and died 3 years after onset. Neuropathological examination showed typical tropical spastic paraparesis (TSP). The polymerase chain reaction (PCR) demonstrated defective proviral genome retaining the HTLV-I pX and env regions in thoracic spinal cord, the level most severely affected. Defective HTLV-I in the nervous system retaining the pX region may be relevant to pathogenesis because circulating CD8+ cytotoxic lymphocytes specific for HTLV-I pX occur in HTLV-I myelopathy. This patient's lymph node biopsy specimen was consistent with Hodgkin's disease (HD), nodular sclerosis subtype, of B-cell origin. The PCR in the paraffin-embedded lymph node involved by HD failed to amplify HTLV-I proviral sequences. Complete HTLV-I proviral amplification was obtained in paraffin-embedded lymph nodes form positive controls (adult T-cell leukemia). To our knowledge the association of TSP and HD has not been reported previously. Despite claims that HD may be associated with HTLV-I, we demonstrated absence of HTLV-I-infected T cells in the lymphoid infiltrate of HD in this case, positive HTLV-I serology notwithstanding.
Navarro-Román
L
L
Department of Pathology, School of Medicine, UT Health Science Center, San Antonio, 78284-7750.
Corbin
D O
DO
Katz
D
D
Callender
D P
DP
Prussia
P R
PR
Garriques
S
S
Fraser
H S
HS
Jaffe
E S
ES
Román
G C
GC
D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D006689:Hodgkin Disease / Q000150:complications / Q000473:pathology / Q000821:virology*; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000150:complications / Q000473:pathology / Q000821:virology*; D013116:Spinal Cord / Q000473:pathology / Q000821:virology*
D004279:DNA, Viral