Gastric lesions in 76 patients with adult T-cell leukemia/lymphoma: Endoscopic evaluation

Sakata, Hiroyuki; Fujimoto, Kazuma; Iwakiri, Ryuichi; Mizuguchi, Masanobu; Kõyama, T.; Sakai, Takahiro; Inoue, Etsuko; Tokunaga, Osamu; Shimamoto, Yoshinori

doi:10.1002/(sici)1097-0142(19960801)78:3<396::aid-cncr3>3.0.co;2-i

Cited by 23 publications

(23 citation statements)

References 19 publications

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“…Adult T-cell leukemia/lymphoma (ATLL) is a devastating T-cell malignancy caused by HTLV-1 [7,8]. ATLL is characterized by a high tendency for leukemic cells to infiltrate various organs including the stomach [9]. Sakata et al demonstrated gastric infiltration of ATLL cells in 23 of 76 patients with ATLL (30.3%) [9].…”

Section: Introductionmentioning

confidence: 99%

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Endocytoscopic findings of lymphomas of the stomach

et al. 2013

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BackgroundThe gastric lesions of various lymphomas were observed at the cellular level using endocytoscopy.MethodsEndocytoscopy and magnifying endoscopy with narrow band imaging (NBI) were performed in 17 patients with lymphomas of the stomach. The lesions consisted of 7 with low-grade mucosa-associated lymphoid tissue (MALT), 5 with gastric involvement by adult T-cell leukemia/lymphoma (ATLL), 4 with diffuse large B-cell lymphoma (DLBCL), and 1 with peripheral T-cell lymphoma.ResultsOn conventional endoscopy, 9 were classified as having superficial spreading type, 7 were mass-forming type, and 1 was diffuse infiltrating type. Anti-H. pylori treatment was given in the 7 MALT lymphoma cases. NBI magnification endoscopy invariably showed dilatation or ballooning and destruction of gastric pits and elongation and distortion in microvessels. Endocytoscopy showed mucosal aggregation of interstitial cellular elements in almost all gastric lymphoma cases. The nuclear diversity in size and configuration was exclusively seen in gastric lymphomas other than MALT lymphoma, whereas the nuclei of MALT lymphoma cells were regular and small to moderate in size. Inter-glandular infiltration by lymphomatous cell elements was frequently observed in MALT lymphoma and DLBCL, but it was uncommon in peripheral gastric T-cell malignancies. Endocytoscopy could identify the disease-specific histology, the lymphoepithelial origin, as inter-glandular infiltration of cellular components in MALT lymphoma and the possibly related DLBCL cases. Complete regression (CR) was observed in 2 of the 7 MALT lymphoma patients. In the 2 patients with CR who underwent repeat endocytoscopy, the ultra-high magnification abnormalities returned to normal, while they were unchanged in those without tumor regression.ConclusionsOn endocytoscopy, intra-glandular aggregation of cellular components was invariably identified in lymphomas of the stomach. Nuclear regularity in size and configuration may indicate the cytological grade, differentiating the indolent low-grade from aggressive lymphoproliferative diseases. The inter-glandular infiltration seen on endocytoscopy can indicate the lymphoepithelial lesions seen in MALT lymphoma and related DLBCL. Endocytoscopy would be applicable for virtual histopathological diagnosis of different lymphoproliferative disorders and their clinical assessment during ongoing endoscopy.

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Section: Introductionmentioning

confidence: 99%

“…ATLL is characterized by a high tendency for leukemic cells to infiltrate various organs including the stomach [9]. Sakata et al demonstrated gastric infiltration of ATLL cells in 23 of 76 patients with ATLL (30.3%) [9]. In contrast, the other gastric T-cell lymphomas without HTLV-1 infection are reported sporadically [6].…”

Section: Introductionmentioning

confidence: 99%

Endocytoscopic findings of lymphomas of the stomach

et al. 2013

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“…The patients included 47 men and 24 women with a mean age of 59 years (range, 33–82 years). ATLL was diagnosed based on the following criteria5, 6, 16: 1) seropositivity against HTLV‐1 tested using a particle agglutination kit (Serodia HTLV‐1; Fuji‐Rebio Company, Tokyo, Japan) and, when indicated, confirmed by an enzyme immunoassay kit (Eitest‐ATL; Eisai Company, Tokyo, Japan); 2) lymphoid neoplasia confirmed histologically and/or hematologically (abnormal lymphoid cells with nuclear irregularity of lobulation and clover‐leaf forms); 3) CD3+, CD4+, CD8−, CD25+, and CD45RO+ immunophenotypes of tumor cells analyzed using a FACSscan flow cytometer (Becton Dickinson, Mountain View, CA); and 4) monoclonal integration of HTLV‐1 provirus in chromosomal DNA by Southern blot analysis 17. The clinical type of ATLL was classified into four groups (acute, lymphoma, chronic, and smoldering) based on the report by the Lymphoma Study Group 16…”

Section: Methodsmentioning

confidence: 99%

“…ATLL is characterized by a high tendency of leukemic cells to infiltrate various organs 3, 4. Gastrointestinal involvement in patients with ATLL also is common 5, 6. Recently, Sakata et al6 demonstrated gastric infiltration of ATLL cells in 23 of 76 patients with ATLL (30.3%).…”

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confidence: 99%

“…Gastrointestinal involvement in patients with ATLL also is common 5, 6. Recently, Sakata et al6 demonstrated gastric infiltration of ATLL cells in 23 of 76 patients with ATLL (30.3%). Cell adhesion molecules expressed on leukemic cells (homing receptors) and on the endothelium (vascular addressins) are considered to play a key role in ATLL cell infiltration,4 a process similar to that described for normal leukocyte transmigration from circulation into the tissue 7…”

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Helicobacter pylori infection in patients with gastric involvement by adult T‐cell leukemia/lymphoma

Ohnita

Isomoto

Mizuta

et al. 2002

Cancer

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BACKGROUND Gastrointestinal involvement is seen frequently in patients with adult T‐cell leukemia/lymphoma (ATLL). The authors previously showed a relatively low prevalence of Helicobacter pylori infection in individuals with human T‐cell lymphotropic virus 1 (HTLV‐1) infection, including patients with ATLL; however, the correlation between H. pylori infection and ATLL gastric involvement has not been investigated. METHODS The authors studied 71 patients with ATLL. Gastric involvement was confirmed by endoscopy and biopsy. H. pylori infection was detected by serology, rapid urease test, and immunohistochemistry on biopsy samples. The expression of adhesion molecules on ATLL cells or their ligands on the vasculature in gastric mucosa was analyzed immunohistochemically. The expression of mucosal addressin cell adhesion molecule 1 (MAdCAM‐1) was detected by reverse transcriptase‐polymerase chain reaction (RT‐PCR) analysis. RESULTS Gastric involvement was detected in 21 patients (30%), including 8 patients with acute clinical subtype ATLL and 13 patients with lymphoma type ATLL. The prevalence of H. pylori infection was 86% (18 of 21 patients) in the patients with gastric involvement but only 38% (19 of 50 patients) in the patients without such involvement (P < 0.001). The expression of lymphocyte function‐associated antigen 1 (LFA‐1) and its ligand, intercellular adhesion molecule 1 (ICAM‐1), was most frequent on ATLL cells infiltrating the stomach and was enhanced substantially on vascular endothelium in H. pylori‐infected gastric mucosa. Human mucosal lymphocyte antigen 1 also was expressed on infiltrating ATLL cells in the stomach. The expression of MAdCAM‐1 mRNA assessed by RT‐PCR also was seen selectively in H. pylori‐infected patients. CONCLUSIONS ATLL cells infiltrate gastric tissues infected with H. pylori, probably through the interaction of adhesion molecules on these cells and their ligands on the vasculature, i.e., through the LFA‐1/ICAM‐1 pathway. Cancer 2002;94:1507–16. © 2002 American Cancer Society. DOI 10.1002/cncr.10367

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Multiple polypoid lesions with erosion of the gastric mucosa in adult T‐cell lymphoma/leukemia superimposed on cytomegalovirus infection

Shimazu

Kouno

Shindo

et al. 2022

eJHaem

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We report here unique endoscopic findings of cytomegalovirus (CMV) gastritis associated with adult T-cell leukemia/lymphoma (ATLL). A 67-year-old Japanese man presented to a hematologist with a month history of appetite loss. Physical examination showed blurred consciousness (GCS E4V2M5) with labored breathing and hypotension. Blood examination revealed hypercalcemia (adjusted Ca: 3.24 mmol/L), anemia (Hb: 70 g/L), and leukocytosis (white blood cell count: 21.3 × 10 9 /L) with abnormal lymphocytes (7%).Human T-cell lymphotropic virus type 1 antibody and provirus DNA monoclonality were positive. A blood transfusion was given, and noradrenaline and denosumab were administered. Upper gastrointestinal tract endoscopy showed multiple polypoid lesions with redness and erosive surface (upper left; see Figure 1). A gastricbiopsy specimen showed the presence of CD3 + CD4 + CD8 − T cells, compatible with the gastric involvement by ATLL, and CMV gastritis presenting with inclusion bodies positive for anti-CMV antibody by immunohistochemistry (upper right and lower left; see Figure 1).CMV antigenemia was present, and soluble interleukin-2 receptor was markedly elevated at 119,194 U/ml. CMV enteritis was also observed. He was treated with ganciclovir for CMV gastroenteritis.

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Gastric lesions in 76 patients with adult T-cell leukemia/lymphoma: Endoscopic evaluation

Abstract: This study demonstrated that 30.3% of patients with ATLL had gastric involvement and 13.2% had peptic ulcers. Gastric involvement of ATLL was one of the prognostic factors in acute type ATLL, whereas it had no influence on the prognosis of lymphoma type ATLL.

Cited by 23 publications

References 19 publications

Endocytoscopic findings of lymphomas of the stomach

Endocytoscopic findings of lymphomas of the stomach

Helicobacter pylori infection in patients with gastric involvement by adult T‐cell leukemia/lymphoma

Multiple polypoid lesions with erosion of the gastric mucosa in adult T‐cell lymphoma/leukemia superimposed on cytomegalovirus infection

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