title: Adult T-Cell Leukaemia-Lymphoma Relapsing as Hodgkin Disease Nodular Sclerosis Subtype.
abstract: Adult T-cell leukaemia-lymphoma (ATLL) is a distinct disease aetiologically associated with HTLV-I. Hypercalcaemia, organomegaly and a pleomorphic blood picture characterized by the presence of convoluted CD4+CD25+ lymphocytes are the main disease features. We report a patient with a well documented ATLL who relapsed after a long-lasting remission induced by deoxycoformycin treatment. At relapse, the blood picture was consistent with ATLL whereas the histological and immunophenotypical features of the lymph node were indistinguishable from those seen in Hodgkin disease (HD) nodular sclerosis subtype. The monoclonal integration of HTLV-I proviral DNA in the lymph node was demonstrated by Southern blot. The unusual evolution of this case emphasizes the difficulties of differential diagnosis between HD and ATLL with atypical histology and adds new support to the concept of a possible viral participation in a subset of HD cases.
authors.forename: L
authors.initials: L
authors.lastname: Escoda
authors.forename: A
authors.initials: A
authors.lastname: Urbano-Ispizua
authors.forename: E
authors.initials: E
authors.lastname: Montserrat
authors.affiliation: a Postgraduate School of Haematology "Farreras-Valentí" and Department of Pathology , London , United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Ordi
authors.forename: A
authors.initials: A
authors.lastname: López-Guillermo
authors.affiliation: b Hospital Clínic de Barcelona , Spain , and Academic Department of Haematology and Cytogenetics London , United Kingdom.
authors.forename: E
authors.initials: E
authors.lastname: Matutes
authors.affiliation: c Institute of Cancer Research, London , United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Reeves
authors.affiliation: c Institute of Cancer Research, London , United Kingdom.
authors.forename: T F
authors.initials: TF
authors.lastname: Schulz
authors.forename: C
authors.initials: C
authors.lastname: Rozman
keywords: Hodgkin Disease; T-Cell Leukaemia