title: Case of adult T-cell leukemia/lymphoma manifesting marked purpura.
abstract: We present a case of a 62-year-old woman with marked purpura, first appearing on both legs, then spreading over the whole body, including the face. At presentation, the patient was thought to have Henoch-Schonlein purpura. However, a skin biopsy from a purpuric lesion revealed prominent infiltrations of atypical lymphocytes into the papillary dermis and marked extravasation of erythrocytes through the epidermis and upper dermis. Antibody to human T-lymphotropic virus type 1 (HTLV-1) was present in the serum and samples from skin lesions revealed HTLV-1 proviral DNA integration, as well as a clonal T-cell receptor Cbeta1 gene rearrangement. We therefore diagnosed this case as adult T-cell leukemia/lymphoma (ATL), and the purpuric lesions as ATL-specific. Soon after the initiation of chemotherapy, these purpuric lesions began to resolve with pigmentation.
authors.affiliation: Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. junoka71@dermatol.med.kyushu-u.ac.jp
authors.forename: Junna
authors.initials: J
authors.lastname: Okada
authors.forename: Shinichi
authors.initials: S
authors.lastname: Imafuku
authors.forename: Jun
authors.initials: J
authors.lastname: Tsujita
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Moroi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Urabe
authors.forename: Masutaka
authors.initials: M
authors.lastname: Furue
mesh_terms: D015139:Blotting, Southern; D005260:Female; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D015368:Human T-lymphotropic virus 1 / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D008214:Lymphocytes / Q000276:immunology; D008875:Middle Aged; D010859:Pigmentation Disorders / Q000209:etiology* / Q000473:pathology; D011693:Purpura / Q000209:etiology* / Q000473:pathology; D012867:Skin / Q000473:pathology / Q000821:virology