title: An Unusual Association of Adult T-Cell Leukemia/Lymphoma With Hyalohyphomycosis.
abstract: Infection by human T-cell lymphotropic virus (HTLV-1) causes deregulation of the immune system, which makes the infected individuals more susceptible to infectious diseases. Immune deregulation is even more pronounced in HTLV-1 carriers with adult T-cell leukemia/lymphoma (ATLL), which results in frequent opportunistic infections. Hyalohyphomycosis is a rare subcutaneous mycosis which is more commonly associated with immunocompromised patients. We report a case of a HTLV-1-infected man with skin tumors, inguinal lymphadenomegaly, and lymphocytosis. Histopathological examination of skin biopsies revealed a T-cell lymphoma intermingled with a granulomatous process with abscesses and hyaline-septated hyphae. The lymph node showed only a T-cell lymphoma. The patient was diagnosed with acute ATLL and hyalohyphomycosis. He was treated with itraconazole for the subcutaneous mycosis and with chemotherapy for ATLL. A few months later, despite the treatment, he died because of progression of ATLL.
authors.affiliation: *Dermatology, and †Hematology Service, and ‡Laboratory of Pathology of the Complexo Hospitalar Universitário Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil.
authors.forename: Pedro Dantas
authors.initials: PD
authors.lastname: Oliveira
authors.forename: Marco Aurélio
authors.initials: MA
authors.lastname: Salvino
authors.forename: Herbert Henrique de Melo
authors.initials: HH
authors.lastname: Santos
authors.forename: Achiléa Lisboa
authors.initials: AL
authors.lastname: Bittencourt
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy; D003881:Dermatomycoses / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D018450:Disease Progression; D017809:Fatal Outcome; D015490:HTLV-I Infections / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D060605:Hyalohyphomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology; D016867:Immunocompromised Host; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D008297:Male; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D000970:Antineoplastic Agents