Lymph nodes in incipient adult T-cell leukemia-lymphoma with Hodgkin's disease-like histologic features

Ohshima, Kohichi; Kikuchi, Masahiro; Yoshida, Takashi; Y, Masuda; Kimura, N.

doi:10.1002/1097-0142(19910315)67:6<1622::aid-cncr2820670625>3.0.co;2-1

Cited by 50 publications

(42 citation statements)

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“…The presence of Hodgkin-like cells in ATLL was originally reported in the Japanese population by Ohshima et al[8], and these cells were thought to be part of the ATLL in view of a T-cell phenotype demonstrable in the HLC similar to the surrounding ATLL cells. A subsequent study observed similar cells in 18 patients with incipient ATLL, half of whom went on to develop overt ATLL [4].…”

Section: Discussionmentioning

confidence: 95%

Adult T-cell leukemia/lymphoma with Epstein-Barr virus–positive Hodgkin-like cells

et al. 2011

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SUMMARY Hodgkin-like cells (HLC) have been described in a variety of non-Hodgkin lymphomas (NHL) including chronic lymphocytic leukemia (CLL) and peripheral T-cell lymphoma (PTCL). There have been rare reports in the Japanese population of human T-cell lymphotrophic virus-1 (HTLV-1)-associated adult T-cell leukemia/lymphoma (ATLL) harboring HLC; however, no similar cases have been described in western patients. We report a 53-year-old African-American man that presented with progressive weakness and lethargy, and was found to have generalized lymphadenopathy and hypercalcemia. A lymph node biopsy showed involvement by ATLL with scattered Epstein-Barr virus (EBV)-positive cells, some of which resembled Hodgkin cells that had a B-cell phenotype, consistent with an Epstein-Barr virus-lymphoproliferative disorder (LPD). The patient had stage 4 disease with bone marrow involvement. In light of the associated B-cell lymphoproliferative process, the patient was treated with six cycles of intensive chemotherapy that targeted both the ATLL and the EBV-LPD that resulted in a complete response. An awareness of the association of EBV-LPD with Hodgkin-like cells in the context of ATLL is necessary to avoid potential misdiagnosis and to aid in therapeutic decisions.

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Section: Discussionmentioning

confidence: 95%

Adult T-cell leukemia/lymphoma with Epstein-Barr virus–positive Hodgkin-like cells

et al. 2011

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“…The latter appear to be non-neoplastic Epstein–Barr virus (EBV)-infected cells, thought to be secondary to the immunodeficiency resulting from the HTLV-I infection. A few cases with a histological pattern resembling Hodgkin disease or angioimmunoblastic T-cell lymphoma have been described 14 15…”

Section: Haematopathological Featuresmentioning

confidence: 99%

Adult T-cell leukaemia/lymphoma

2007

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Adult T-cell leukaemia/lymphoma (ATLL) is a mature T-cell neoplasm of post-thymic lymphocytes aetiologically linked to the human T-cell lymphotropic virus, HTLV-I, and with a distinct geographical distribution. The disease manifests with leukaemia in greater than two thirds of patients, while the remaining patients have a lymphomatous form. According to the disease manifestations, various forms which differ in clinical course and prognosis have been recognised: acute, chronic, smouldering and lymphoma. Organomegaly, skin involvement, circulating atypical lymphocytes ("flower" cells) with a CD4+ CD25+ phenotype and hypercalcaemia are the most common disease features. The diagnosis should be based on a constellation of clinical features and laboratory investigations. The latter comprise: lymphocyte morphology, immunophenotype, histology of the tissues affected in the pure lymphoma forms and serology or DNA analysis for HTLV-I. The differential diagnosis of ATLL includes other mature T-cell neoplasms such as T-cell prolymphocytic leukaemia (T-PLL), Sézary syndrome (SS), peripheral T-cell lymphomas and occasionally healthy carriers of the virus or Hodgkin disease. The clinical course is aggressive with a median survival of less than 12 months in the acute and lymphoma forms. Despite major advances in understanding the pathogenesis of the disease, management of these patients remains a challenge for clinicians as they do not respond or achieve only transient responses to therapies used in high-grade lymphomas. The use of antiretroviral agents such as zidovudine in combination with interferon-alpha, with or without concomitant chemotherapy, has shown activity in this disease with improvement in survival and response rate. Consolidation with high dose therapy and autologous or allogeneic stem-cell transplantation should be considered in young patients.

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“…[9][10][11][12][13][14] In addition to the typical ATL lymphoma of pleomorphic and anaplastic large cell types, we described lymph nodes with a peculiar Hodgkin's disease-like histology in patients who were positive for ATL antigen (ATLA) and showed prodromal clinical features. 10 We also reported HTLV-I-associated lymphadenitis, a non-neoplastic HTLV-I-associated lymph node lesion. 11 Furthermore, in some cases of chronic and smouldering type, atypical cells are usually small in size with an irregular configuration.…”

Section: Introductionmentioning

confidence: 99%

Survival of patients with HTLV-I-associated lymph node lesions

et al. 1999

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Adult T‐cell leukaemia/lymphoma (ATLL), is a malignant condition associated with human T‐cell leukaemia virus type I (HTLV‐I). Usually, although not uniformly, histopathological examination of the lymph nodes shows a pleomorphic type. In addition, some patients with pre‐overt ATLL show a Hodgkin's disease‐like morphology and lymph nodes in non‐neoplastic carriers show features of lymphadenitis. To characterize further the clinicopathological features of HTLV‐I‐associated lymphadenopathy, the histopathological features of the lymph nodes of 289 patients were classified into five types: lymphadenitis ( n=14), Hodgkin's‐like (Hodgkin's) ( n=18), pleomorphic (medium and large cells) ( n=219), pleomorphic small cell ( n=11), and anaplastic large cell (ALC) ( n=27). Survival data were analysed according to the histopathological features of the lymph nodes. The pleomorphic type, which showed typical features of ATLL, was associated with a highly aggressive course and an initially high mortality, followed by a rapid decrease in survival. This pattern was also observed in patients with the ALC type. All cases with lymphadenitis were still alive at the end of the study, while survival progressively decreased in the Hodgkin's type. The small cell type showed an initial rapid decrease in survival followed by a plateau. These results show that the survival trends of patients with pleomorphic and anaplastic lymph node lesions are similar to those with ATL lymphoma, while patients with the lymphadenitis type of lesion were considered to have a non‐neoplatic status. There is at present no effective therapy for ATLL, but in the future, these classification and survival data might be useful for the selection of appropriate chemotherapeutic regimens for patients with ATLL. Copyright © 1999 John Wiley & Sons, Ltd.

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Lymph nodes in incipient adult T-cell leukemia-lymphoma with Hodgkin's disease-like histologic features

Cited by 50 publications

References 14 publications

Adult T-cell leukemia/lymphoma with Epstein-Barr virus–positive Hodgkin-like cells

Adult T-cell leukemia/lymphoma with Epstein-Barr virus–positive Hodgkin-like cells

Adult T-cell leukaemia/lymphoma

Survival of patients with HTLV-I-associated lymph node lesions

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