Primary cutaneous smoldering adult T-cell leukemia/ lymphoma.
HTLV-1 is a virus that is endemic in southwesternJapan and the Caribbean and has been implicatedin the development of ATLL. ATLL, which is anuncommon malignant condition of peripheralT-lymphocytes, is characterized by four clinicalsubtypes, which include acute, lymphomatous,chronic, and smoldering types, that are based onLDH levels, calcium levels, and extent of organinvolvement. We present a 52-year- old woman withpruritic patches with scale on the buttocks and withtender, hyperpigmented macules and papules oftwo-years duration. Histopathologic examinationwas suggestive of mycosis fungoides, laboratoryresults showed HTLV-I and II, and the patient wasdiagnosed with primary cutaneous ATLL. We reviewthe literature on HTLV-1 and ATLL and specifically theprognosis of cutaneous ATLL. The literature suggeststhat a diagnosis of ATLL should be considered amongpatients of Caribbean origin or other endemicareas with skin lesions that suggest a cutaneousT-cell lymphoma, with clinicopathologic features ofmycosis fungoides. Differentiation between ATLLand cutaneous T-cell lymphoma is imperative as theyhave different prognoses and treatment approaches.
Ronald O. Perelman Department of Dermatology, NYU School of Medicine, NYU Langone Medical Center.
Julia
J
Gittler
Kathryn
K
Martires
Vitaly
V
Terushkin
Nooshin
N
Brinster
David
D
Ramsay
D000754:Anemia, Refractory, with Excess of Blasts / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D015153:Blotting, Western; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015481:HTLV-I Antibodies / Q000276:immunology; D015482:HTLV-II Antibodies / Q000276:immunology; D015368:Human T-lymphotropic virus 1 / Q000276:immunology; D015367:Human T-lymphotropic virus 2 / Q000276:immunology; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology
D015481:HTLV-I Antibodies; D015482:HTLV-II Antibodies