Development of peripheral T-cell lymphoma not otherwise specified in an HTLV-1 carrier

• Published in: International journal of hematology Vol. 97; no. 5; pp. 667 - 672
• Main Authors: Ishigaki, Tomohiro, Isobe, Masamichi, Kobayashi, Seiichiro, Yuji, Koichiro, Ohno, Nobuhiro, Watanabe, Nobukazu, Tojo, Arinobu, Uchimaru, Kaoru
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.05.2013; Springer; Springer Nature B.V
• Subjects: Aged; Biological and medical sciences; Carrier State - virology; Case Report; Female; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Hematologic and hematopoietic diseases; Hematology; HTLV-I Infections - virology; Human T-lymphotropic virus 1; Humans; Immunophenotyping; Infectious diseases; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymph Nodes - pathology; Lymphocytes - metabolism; Lymphocytes - pathology; Lymphoma, T-Cell, Peripheral - diagnosis; Lymphoma, T-Cell, Peripheral - etiology; Medical sciences; Medicine; Medicine & Public Health; Oncology; Proviruses; Receptors, Antigen, T-Cell, alpha-beta - genetics; Viral diseases; Virus Integration; Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS); Adult T-cell leukemia (ATL); Multicolor flow cytometry; Human T-cell leukemia virus type 1 (HTLV-1); Flow cytometry; Adult T cell leukemia; Deltaretrovirus; Hematology; Retroviridae; Malignant hemopathy; Non Hodgkin lymphoma; Peripheral T cell lymphoma; Infection; Virus; Lymphoproliferative syndrome; Viral disease; HTLV-I virus; Cancer
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-013-1314-z

Human T-cell leukemia virus type 1 (HTLV-1) causes adult T-cell leukemia (ATL) after a long latency period of about 60 years. As the mature T-cell neoplasms that emerge in patients infected with HTLV-1 are often ATL, T-cell neoplasms developing in such patients tend to be diagnosed simply as ATL without further investigation. However, not all T-cell neoplasms that develop in HTLV-1-infected cases are ATL. Mature T-cell malignancies other than ATL should be carefully excluded in patients infected with HTLV-1, as these sometimes closely resemble ATL in their clinical, morphological, and histological features. Here, we present a case of peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) in an HTLV-1 carrier. Confirmation of monoclonal integration of the virus with Southern blotting leads to a definite diagnosis of ATL. Although we did not detect the monoclonal integration band of HTLV-1 in this case, the high HTLV-1 proviral load complicated the diagnosis. Multicolor flow cytometric analysis clearly showed that HTLV-1 was not integrated in the tumor cells, and facilitated discrimination of PTCL-NOS from ATL.