title: Non-Hodgkin's lymphoma of Waldeyer's ring as a manifestation of lymphoproliferative diseases associated with human T-cell leukemia virus type 1 in southwestern Japan.
abstract: Adult T-cell leukemia/lymphoma (ATL) usually presents with node- and/or cutaneous-based diseases, with a leukemic picture. It is not clear whether ATL initially manifests with lesions in Waldeyer's ring (WR) in an ATL-endemic area. In the present study, we examined distributions of immunophenotypes and the presence of human T-cell leukemia virus type 1 (HTLV-1) and Epstein-Barr virus (EBV) genomes in 62 cases of non-Hodgkin's lymphoma (NHL) of WR (NHL-WR) from two areas of Japan: Osaka, an ATL-nonendemic area (25 cases), and Okinawa, an ATL-endemic area (37 cases). In both areas, age ranged from 10 to 94 years (median, 64 yr), with a male-to-female ratio of 1.81:1. Twelve patients were in Stage I, 34 in Stage II, and 6 in Stage III; stage was unknown in 10. The 25 Osaka cases were B-cell type (16 diffuse immunoblastic type (DIB), 8 diffuse large cell predominantly noncleaved cell (DLNC), 1 cleaved cell (DLC)). Of the 37 Okinawa cases, 20 were B-cell type (3 DIB, 10 DLNC, 2 DLC, 5 other). The remaining 17 cases showed T-cell phenotype (4 DIB, 3 DLC, 3 diffuse large cell not otherwise specified, 7 other). There was a significant difference in the distribution of immunophenotypes between these two areas (P < .001). Combined studies of polymerase chain reaction (PCR) and in situ hybridization revealed the presence of EBV genome in 1 (4%) of 24 Osaka cases, 2 (13%) of 16 B-cell NHLs from Okinawa, and 3 (23%) of 13 T-cell NHLs from Okinawa. HTLV-1 proviral genome was found in 11 (85%) of 13 T-cell lymphomas from Okinawa but could not be detected in B-cell lymphomas from Osaka and Okinawa. Combined clinical, histologic, serologic, and PCR findings suggest that NHL-WR in an ATL-endemic area could be an initial manifestation of ATL.
authors.affiliation: Department of Pathology, Osaka University Medical School, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tomita
authors.forename: M
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Y
authors.initials: Y
authors.lastname: Mishiro
authors.forename: T
authors.initials: T
authors.lastname: Itokazu
authors.forename: S
authors.initials: S
authors.lastname: Kojya
authors.forename: Y
authors.initials: Y
authors.lastname: Noda
authors.forename: O
authors.initials: O
authors.lastname: Ikehara
authors.forename: K
authors.initials: K
authors.lastname: Aozasa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics; D015368:Human T-lymphotropic virus 1 / Q000235:genetics*; D006801:Humans; D016130:Immunophenotyping; D017403:In Situ Hybridization; D007564:Japan; D015458:Leukemia, T-Cell / Q000235:genetics* / Q000276:immunology; D008228:Lymphoma, Non-Hodgkin / Q000235:genetics* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D014067:Tonsillar Neoplasms / Q000235:genetics* / Q000276:immunology