title: Prolonged lymphocytosis as the first manifestation of Hodgkin-like adult T-cell leukemia/lymphoma.
abstract: Hodgkin-like ATLL is a rare variant of adult T-cell leukemia/lymphoma (ATLL), a disease caused by human T-cell lymphotropic virus type-1 (HTLV-1). At admission, a 46-year-old female presented with lymphadenomegaly, lymphocytosis, slight elevation of LDH blood level, and acid-alcohol resistant bacilli in sputum and was being treated for pulmonary tuberculosis (Tb). She had lymphocytosis in the previous 20 months. Serology for HTLV-1 was positive. Lymph node was infiltrated by medium-sized lymphocytes with scattered Hodgkin and Reed-Sternberg-like cells CD30+, CS1-4+, and CD79a+. Background cells were CD4+ and CD25+. A clinical diagnosis of favorable chronic ATLL was given. She was treated with chemotherapy but later progressed to acute ATLL and ultimately died. Hodgkin-like ATLL should be considered in the histological differential diagnosis with Hodgkin lymphoma since treatment and prognosis of these diseases are distinct. It is also important to search for HTLV-1 infection in patients with unexplained prolonged lymphocytosis.
authors: Universidade Federal da Bahía, Hospital Universitário Professor Edgard Santos, Departmento de Patologia, Salvador, BA, Brazil. Electronic address: achilea@uol.com.br.
authors: Achiléa L
authors: AL
authors: Bittencourt
authors: Universidade Federal da Bahía, Hospital Universitário Professor Edgard Santos, Departmento de Patologia, Salvador, BA, Brazil.
authors: Agnes Carvalho
authors: AC
authors: Andrade
authors: Universidade Federal da Bahía, Hospital Universitário Professor Edgard Santos, Departmento de Medicina Interna, Salvador, BA, Brazil.
authors: Cristiane
authors: C
authors: Requião
authors: Universidade Federal da Bahía, Hospital Universitário Professor Edgard Santos, Departmento de Medicina Interna, Salvador, BA, Brazil.
authors: Maria da Gloria Bomfim
authors: MD
authors: Arruda
authors: Universidade Federal da Bahía, Hospital Universitário Professor Edgard Santos, Departmento de Patologia, Salvador, BA, Brazil.
authors: Iguaracyra
authors: I
authors: Araújo
mesh_terms: D001706:Biopsy; D004797:Enzyme-Linked Immunosorbent Assay; D017809:Fatal Outcome; D005260:Female; D015490:HTLV-I Infections / Q000473:pathology*; D006689:Hodgkin Disease / Q000473:pathology* / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000473:pathology* / Q000821:virology; D008198:Lymph Nodes / Q000473:pathology; D008218:Lymphocytosis / Q000473:pathology* / Q000821:virology; D008875:Middle Aged
keywords: Adult T-cell leukemia/lymphoma; HTLV-1 infection; Hodgkin-like ATLL; Pulmonary tuberculosis