Title |
Prolonged lymphocytosis as the first manifestation of Hodgkin-like adult T-cell leukemia/lymphoma
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Published in |
Brazilian Journal of Infectious Diseases, October 2016
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DOI | 10.1016/j.bjid.2016.09.005 |
Pubmed ID | |
Authors |
Achiléa L. Bittencourt, Agnes Carvalho Andrade, Cristiane Requião, Maria da Gloria Bomfim Arruda, Iguaracyra Araújo |
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. |
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Geographical breakdown
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Brazil | 1 | 4% |
Unknown | 26 | 96% |
Demographic breakdown
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Student > Postgraduate | 3 | 11% |
Other | 4 | 15% |
Unknown | 3 | 11% |
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