title: [Two cases of adult T-Cell leukemia/lymphoma with main lesion in stomach treated by VCAP-AMP-VECP regimen].
abstract: We report two cases of adult T-cell leukemia/lymphoma(ATLL)having their main lesions in the stomach. Case 1 was a 74-year-old man, complaining of left upper abdominal mass and pain. Upper gastrointestinal endoscopy revealed an ulcerous lesion in the stomach. Histological analysis and southern blotting for HTLV-1 pro-viral DNA led us to our diagnosis of ATLL. There were no apparent lesions in the bone marrow and other organs. He died of tumor lysis and multi-organ failure shortly after treatment with the VCAP-AMP-VECP regimen. Case 2 was a 68-year-old man complaining of abdominal bloating and pain. Upper gastrointestinal endoscopy disclosed an irregularity of the gastric mucosa. A biopsy sample was diagnosed pathohistologically as non-Hodgkin's lymphoma. We conducted total gastrectomy. Based on the results from the histological study and southern blotting for HTLV-1 p ro-viral DNA in the resected specimen, a diagnosis of ATLL was made. We treated him with a VCAP-AMP-VECP regimen, but multiple bone metastases and pathologic fracture occurred, proving that the disease was progressive. ATLL having a main lesion in the stomach is rare, and requires an accumulation of cases analyzed with careful diagnostic approach to establish a standard therapy for it.
authors.affiliation: Dept. of Hematology, Social Insurance Funabashi Central Hospital.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ishizuka
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ozawa
authors.forename: Shin
authors.initials: S
authors.lastname: Tsuchiya
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Shirai
authors.forename: Kazuki
authors.initials: K
authors.lastname: Katoh
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ohtsuka
authors.forename: Teisuke
authors.initials: T
authors.lastname: Komatsu
authors.forename: Motoharu
authors.initials: M
authors.lastname: Fukazawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery / Q000821:virology; D008297:Male; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery / Q000821:virology; D016896:Treatment Outcome