Adult T-cell leukaemia/lymphoma can mimic other lymphomas in a non-endemic area: dilemmas in diagnosis and treatment.
Intern Med J
; 44(4): 374-83, 2014 Apr.
Article
em En
| MEDLINE
| ID: mdl-24533861
ABSTRACT
BACKGROUND:
The diagnosis of Adult T-cell leukaemia/lymphoma (ATL) in non-endemic regions is challenging.AIM:
This study analyses the clinicopathologic features and diagnostic processes of ATL patients in Taiwan.METHODS:
ATL patients diagnosed and treated at Taipei Veterans General Hospital from 1998 through 2010 were retrospectively identified. The diagnosis of ATL was confirmed by in situ detection of human T-cell leukaemia virus type 1 (HTLV-1) when necessary. Patients' data were reviewed and analysed.RESULTS:
Fourteen ATL patients were identified, among whom six (42.9%) had an antecedent diagnosis of other malignant lymphomas before the ATL diagnosis, including two diagnosed with Hodgkin disease (HD), one with peripheral T-cell lymphoma, two with chronic lymphocytic leukaemia and one with angioimmunoblastic T-cell lymphoma. Of the 14 patients, eight (57%) were subclassified as the acute type, three (21.4%) as the lymphoma type, and three (21.4%) as the chronic type ATL. Five of six (83.3%) patients with initial non-ATL misdiagnosis were diagnosed with non-acute type ATL. In particular, a patient with an antecedent diagnosis of HD presented with typical Reed-Sternberg (RS)-like cells harbouring Epstein-Barr virus genomes in affected lymph nodes. The patient progressed to acute type ATL 3 years after the initial diagnosis, and HTLV-1 genomes were identified in the previous RS-like cells.CONCLUSION:
In non-endemic areas, such as Taiwan, ATL, particularly the non-acute type, may mimic other lymphomas and easily be misdiagnosed. HTLV-1 serology should be routinely screened in all malignant lymphoma patients. In situ detection of HTLV-1 is helpful in cases with diagnostic dilemmas.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
DNA Viral
/
Vírus Linfotrópico T Tipo 1 Humano
/
Leucemia-Linfoma de Células T do Adulto
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article