Cutaneous granulomas associated with adult T-cell leukemia/lymphoma.
A 59-year-old Japanese woman showed recurrent violaceous, indurated erythemas and papules on the buttocks and extremities for a period of 7 years. The lesions showed histologically epithelioid cell granulomas associated with lymphocytes. After 7 years, the patient developed adult T-cell leukemia (ATL), of the acute type, the course of which was fatal. Immunohistochemical staining of the skin sections of granulomatous lesions showed prominent infiltration of CD25-positive cells. Human T-lymphotropic virus type I proviral DNA and monoclonal T-cell receptor beta gene rearrangement were detected in the skin samples by a retrospectively performed gene analysis. We believe that the patient initially had an unusual cutaneous type of ATL in which granulomas occurred as a host-protective response against ATL progression.
Higaki
Yuko
Y
Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan. y-higaki@derm.twmu.ac.jp
Mizushima
Junichi
J
Kawashima
Makoto
M
Motoji
Toshiko
T
Mizoguchi
Hideaki
H
D004279:DNA, Viral / Q000032:analysis; D015622:Epithelioid Cells / Q000473:pathology; D005260:Female; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D006099:Granuloma / Q000150:complications* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D015368:Human T-lymphotropic virus 1 / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D011533:Proviruses / Q000235:genetics; D015375:Receptors, Interleukin-2 / Q000032:analysis; D012867:Skin / Q000276:immunology / Q000473:pathology / Q000821:virology; D012871:Skin Diseases / Q000150:complications* / Q000235:genetics / Q000276:immunology / Q000473:pathology
D004279:DNA, Viral; D015375:Receptors, Interleukin-2