A Case of Adult T Cell Leukemia with CD4- and CD8- Complicated with Gastric Cancer

• Published in: Journal of the Japan Society of the Reticuloendothelial System Vol. 33; no. 3; pp. 201 - 207
• Main Authors: Shimotakahara, Shigemi, Otsuka, Maki, Ishibashi, Kazuaki, Arima, Terukatsu, Hanada, Shuichi, Chuman, Yoshiko, Utsunomiya, Atae, Sato, Eiichi, Tokudome, Takahiro, Tokunaga, Masayoshi, Kisanuki, Rie, Nakahara, Katsushi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Lymphoreticular Tissue Research 1993
• Subjects: adult T cell leukemia; double cancer; gastric cancer; surface phenotype
• ISSN: 0386-9725; 1883-6801
• DOI: 10.3960/jslrt1961.33.201

An eighty-four-year-old man was admitted to our hospital because of nasal obstruction and swelling of bilateral neck lymph nodes on March 27, 1990; an epipharyngeal tumor was noted. No hepatosplenomegaly or skin lesions were seen. Laboratory examination revealed anemia and a high serum level of lactic dehydrogenase. A serum sample was positive for anti-human T cell leukemia virus type 1 antibody. A biopsy specimen of the epipharyngeal tumor revealed malignant lymphoma of a diffuse pleomorphic type, according to the Lymphoma Study Group classification. Lymphoma cells showed CD2 and CD3, but no CD4, CD8 or CD25. Endoscopic examination of the stomach showed a Borrmann type 1 tumor on the posterior wall of the gastric angle. A biopsy specimen revealed moderately well-differentiated adenocarcinoma. We therefore diagnosed this as lymphoma-type adult T cell leukemia (ATL) complicated with gastric cancer. Combination chemotherapy for ATL succeeded but the patient relapsed 1 month after achieving complete remission and died of tumor progression. Autopsy was not permitted. We confirmed the monoclonal integration of HTLV-1 proviral DNA in the cells from a relapsed lymph node by Southern blot hybridization. We reviewed and discussed the literature on surface phenotype of ATL and double cancer in ATL.