Human T-lymphotropic virus type-1 related adult T-cell leukemia/lymphoma presenting as a parotid mass diagnosed by fine-needle aspiration biopsy.
A 48-yr-old black woman with a history of blood transfusions for menorrhagia secondary to uterine fibroids but no known Caribbean association presented with a 6-wk history of a rapidly enlarging right parotid mass. At the time of presentation, she could not close her right eye. An aspiration biopsy showed small, medium, and large lymphoma cells with angulated nuclei, red macronucleoli, and basophilic cytoplasm with fine vacuoles. Flow cytometry indicated a (CD25(+)/CD7(-)) T-cell lineage, suggesting an human T-lymphotropic virus (HTLV) 1-related T-cell leukemia/lymphoma, which was confirmed by polymerase chain reaction (PCR)-based amplification on DNA extracted from fresh tissue with specific oligonucleotide primers for HTLV-1 DNA sequence. Histology showed interstitial infiltration and destruction of the parotid parenchyma by lymphoma cells without involvement of adjacent lymph nodes. Total body CT scan and magnetic resonance imaging (MRI) studies were negative for lymphadenopathy but showed liver metastasis. To our knowledge, this is the first reported case of HTLV-1-related primary parotid lymphoma as the initial presentation of adult T-cell leukemia/lymphoma.
Department of Pathology, New York University School of Medicine, New York, New York 10016, USA.
Guo-Xia
GX
Tong
Osvaldo
O
Hernandez
Herman T
HT
Yee
Shyun-Hua
SH
Zheng
Grace C H
GC
Yang
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D044963:Biopsy, Fine-Needle / Q000379:methods*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004279:DNA, Viral / Q000032:analysis; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016130:Immunophenotyping; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D016399:Lymphoma, T-Cell / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D008875:Middle Aged; D010306:Parotid Gland / Q000473:pathology* / Q000821:virology; D010307:Parotid Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D016133:Polymerase Chain Reaction; D011241:Prednisone / Q000008:administration & dosage; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D004279:DNA, Viral; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone