Adult T-cell leukemia/lymphoma complicated by Pneumocystis pneumonia in a non-endemic area

Kunimoto, Mayu; Inomata, Minoru; Chin, Haruka; Yu, I.; Fujimoto, Kazushi; Muto, Y.; Nomura, Masashi; Sato, Kota; Sakamoto, Keita; Awano, Nobuyasu; Kuse, Naoyuki; Kumasaka, Takashi; Takemura, Tamiko; Izumo, Takehiro

doi:10.1016/j.rmcr.2023.101807

Cited by 1 publication

(2 citation statements)

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“…In some cases of PCP associated with CTCL other than MF, atypical cells were all found in the peripheral blood, and the condition was diagnosed as leukosis [ 7 , 8 ]. No atypical cells were found in the peripheral blood in the present case; however, the smear test was performed only once.…”

Section: Discussionmentioning

confidence: 99%

“…MF is clinically characterized by progression from patches to tumors and histologically by an epidermotropic infiltrate of small-to medium-sized CD4+ T cells [6]. Because of primary cutaneous lymphoma, MF is unlikely to suppress the immune system unless it develops leukosis or is treated with anticancer or immunosuppressive agents [7][8][9]. We encountered a case of PCP that developed in a patient with mild MF without leukosis and prior treatment with anticancer drugs or systemic immunosuppressive agents.…”

Section: Introductionmentioning

confidence: 99%

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Pneumocystis jirovecii Pneumonia in a Patient With Localized Mycosis Fungoides Not Receiving Immunosuppressive Treatment

Kudoh,

Komiya,

Takaki

et al. 2024

Cureus

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection in patients with human immunodeficiency virus (HIV), but it may develop in patients without HIV, whose immune system is suppressed by anticancer or immunosuppressive agents even when indicating normal counts of CD4+ T cells. Mycosis fungoides (MF) is a primary cutaneous T-cell lymphoma, which is believed not to cause immunosuppressive conditions unless it develops leukosis or metastasis or is treated with anticancer drugs or systemic immunosuppressants. Here, we report a case of PCP in a patient with localized MF not receiving immunosuppressive treatment. The patient, a woman in her 70s, presented with persistent dyspnea. High-resolution computed tomography (HRCT) showed diffuse ground-glass opacities in both lungs. Bronchoalveolar lavage fluid was positive for P. jirovecii . Moreover, the cytomegalovirus antigenemia test was positive, whereas tests for anti-HIV and antihuman T-cell lymphotropic virus antibodies were negative. The patient was treated with trimethoprim-sulfamethoxazole, prednisolone, and ganciclovir, which gradually improved the symptoms and diminished diffuse ground-glass opacities on HRCT. This case exemplifies a rare presentation of PCP with mild MF that was not treated with chemotherapy or immunosuppressants. The possible mechanisms for the development of PCP are discussed.

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Section: Discussionmentioning

confidence: 99%