title: Bilateral orbital tumor as initial presenting sign in human T-cell leukemia virus-1 associated adult T-cell leukemia/lymphoma.
abstract: OBJECTIVE
  To report a case of human T-cell leukemia virus type1 (HTLV-1)-associated adult T-cell leukemia/lymphoma (ATLL) whose initial sign was exophthalmos.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A 64-year-old Japanese man presented with exophthalmos and choroidal folds of the right eye without general symptoms and received ophthalmologic and laboratory examination, magnetic resonance imaging (MRI), and orbital biopsy.
  
  
  RESULTS
  Antibodies against HTLV-1 were extremely high but atypical lymphocytes were not present in the peripheral blood. MRI showed multiple tumorous lesions in both orbits. Orbital biopsy revealed an orbital mass that consisted of atypical lymphocytes originally from T cells and established the diagnosis of lymphoadenopathy type of ATLL.
  
  
  CONCLUSIONS
  Although ocular involvement by ATLL is extremely rare, ATLL can first present in the orbit, and only the results of a biopsy can provide definitive information for its diagnosis.
authors.affiliation: Department of Ophthalmology, Kansai Medical University, Osaka, Japan.
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ogata
authors.forename: Kanji
authors.initials: K
authors.lastname: Takahashi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Uemura
authors.forename: Miyo
authors.initials: M
authors.lastname: Matsumura
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D015703:Antigens, CD / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D015862:Choroid Diseases / Q000175:diagnosis; D004279:DNA, Viral / Q000032:analysis; D005094:Exophthalmos / Q000175:diagnosis; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D013601:T-Lymphocytes / Q000473:pathology / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D015703:Antigens, CD; D004279:DNA, Viral