title: Adult T-cell leukemia/lymphoma with Epstein-Barr virus-positive Hodgkin-like cells.
abstract: Hodgkin-like cells have been described in a variety of non-Hodgkin lymphomas including chronic lymphocytic leukemia and peripheral T-cell lymphoma. There have been rare reports in the Japanese population of human T-cell lymphotrophic virus-1-associated adult T-cell leukemia/lymphoma harboring Hodgkin-like cells; however, no similar cases have been described in Western patients. We report a 53-year-old African American man who presented with progressive weakness and lethargy, and was found to have generalized lymphadenopathy and hypercalcemia. A lymph node biopsy showed involvement by adult T-cell leukemia/lymphoma with scattered Epstein-Barr virus-positive cells, some of which resembled Hodgkin cells that had a B-cell phenotype, consistent with an Epstein-Barr virus-lymphoproliferative disorder. The patient had stage 4 disease with bone marrow involvement. In light of the associated B-cell lymphoproliferative process, the patient was treated with 6 cycles of intensive chemotherapy that targeted both the adult T-cell leukemia/lymphoma and the Epstein-Barr virus-lymphoproliferative disorder that resulted in a complete response. An awareness of the association of Epstein-Barr virus-lymphoproliferative disorder with Hodgkin-like cells in the context of adult T-cell leukemia/lymphoma is necessary to avoid potential misdiagnosis and to aid in therapeutic decisions.
authors.affiliation: Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. gvenkat@lumc.edu
authors.forename: Girish
authors.initials: G
authors.lastname: Venkataraman
authors.forename: Jonathan
authors.initials: J
authors.lastname: Berkowitz
authors.forename: John C
authors.initials: JC
authors.lastname: Morris
authors.forename: John E
authors.initials: JE
authors.lastname: Janik
authors.forename: Mark A
authors.initials: MA
authors.lastname: Raffeld
authors.forename: Stefania
authors.initials: S
authors.lastname: Pittaluga
mesh_terms: D001402:B-Lymphocytes / Q000473:pathology*; D020031:Epstein-Barr Virus Infections / Q000473:pathology* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged