A case of adult T cell leukemia and lymphoma in an Italian woman showing different malignant clones in tumor mass and in blood.
HTLV-1 infections and their associated diseases are very rare in Italy, as well as in most parts of Europe, occurring prevalently in subjects related to endemic areas. The HTLV-1-associated leukemia/lymphoma, ATLL, is a very aggressive T-cell non-Hodgkin's lymphoma which can be difficult to recognize in non-endemic areas. Here we describe the case of an elderly Italian woman, with no apparent risk factors, affected by a rapidly fatal ATLL who presented with an abdominal lymphomatous mass and circulating leukemic cells. The simultaneous presence of different T-cell clones in the tumor mass and in the blood was demonstrated by T-cell receptor gene rearrangement analysis and HTLV-1 integration pattern studies. After surgery, all the T-cell clones were present in the blood, indicating that tumor cells had spread from the mass. Phylogenetic analysis, using the complete LTR sequence, showed that the patient's HTLV-1 isolate belongs to the cosmopolitan subtype A.
Menin
Chiara
C
Cytodiagnostic and Molecular Oncology Unit, Azienda Ospedaliera di Padova, via Gattamelata 64, 35128 Padova, Italy.
Bulian
Pietro
P
Filippi
Fausto
F
Buttarello
Mauro
M
Casado
Concepcion
C
Lopez-Galindez
Cecilio
C
De Rossi
Anita
A
Chieco-Bianchi
Luigi
L
Del Mistro
Annarosa
A
D000328:Adult; D000368:Aged; D001773:Blood Cells / Q000276:immunology; D002999:Clone Cells; D005260:Female; D015329:Gene Rearrangement, T-Lymphocyte; D015368:Human T-lymphotropic virus 1 / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007558:Italy; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D010802:Phylogeny; D013601:T-Lymphocytes / Q000276:immunology; D016662:Virus Integration