Thoracic manifestations of adult T-cell leukemia/lymphoma on chest CT: difference between clinical subtypes

Yogi, Satoko; Yamashiro, Tsuneo; Kamiya, Hisashi; Kamiya, Ayano; Miyara, Tetsuhiro; Moromizato, Hidekazu; Murayama, Sadayuki

doi:10.5152/dir.2018.18038

Cited by 7 publications

(4 citation statements)

References 18 publications

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“… 4 The incidence of abnormal findings was higher in aggressive ATLL than in indolent ATLL. 5 In the present case, aggressive ATLL was suspected because of the extensive ground‐glass opacities on chest CT and abnormal T lymphocytes and flower cells in peripheral blood. Some reports showed that HTLV‐1‐associated pulmonary diseases were caused by HTLV‐1‐infected lung epithelial cells, 6 and another showed pulmonary infiltration of ATLL cells on lung biopsy.…”

Section: Discussionmentioning

confidence: 78%

Cryobiopsy for Pneumocystis jirovecii pneumonia secondary to adult T‐cell lymphoma/leukaemia

Kobe

Saito

Arita

et al. 2021

Respirology Case Reports

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A 79‐year‐old woman presented to the emergency department with a 1‐week history of progressively worsening dyspnoea on exertion. Chest computed tomography (CT) showed bilateral consolidation. On laboratory findings, the line blot assay for human T‐cell leukaemia virus type 1 was positive, the white blood cell count was 33,000/μl (atypical lymphocytes 8500/μl, 26% of the total white blood cell count) and β‐ d ‐glucan was increased to 391.1 pg/ml. In bronchoalveolar lavage fluid, there was a small number of atypical lymphocytes, and the polymerase chain reaction for Pneumocystis jirovecii was positive. Sulfamethoxazole‐trimethoprim and corticosteroid were administered, but the lung shadows remained. Adult T‐cell lymphoma/leukaemia (ATLL) cell infiltration was suspected, and transbronchial lung cryobiopsy was performed, which showed no infiltration of lymphoma cells into the lung. The lung shadow showed an improving trend on chest CT. She was diagnosed with chronic type ATLL and discharged without chemotherapy.

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Section: Discussionmentioning

confidence: 78%

Cryobiopsy for Pneumocystis jirovecii pneumonia secondary to adult T‐cell lymphoma/leukaemia

Kobe

Saito

Arita

et al. 2021

Respirology Case Reports

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show abstract

“…In acute and lymphoma-type ATLL, CT findings of ATLL lung lesions include enlarged lymph nodes, ground-glass attenuation, bronchial wall thickening, nodules, which are not characteristic of PCP, and centrilobular opacities [ 20 ]. In our patient, the main pathological findings of the cryobiopsy sample were CD3, 4, and 5 positive atypical lymphocytes infiltrating into the bronchiole walls, corresponding to bronchial wall thickening on CT. Thickened interlobular septa and enlarged hilar and mediastinal lymph nodes were consistent with lung lesions of ATLL as written above.…”

Section: Discussionmentioning

confidence: 99%

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

Kunimoto¹,

Inomata²,

Chin³

et al. 2023

Respiratory Medicine Case Reports

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“…Even in the cases of chronic and smoldering types, pulmonary infiltration of ATL cells is detected [ 10 ]; and, bronchoscopic examinations play a key role in the diagnosis. Patients with both ATL and pulmonary complications demonstrate several abnormal findings on chest CT, such as ground-glass attenuation, centrilobular nodules, thickening of bronchovascular bundles, and consolidation [ 11 ]. If chest radiography reveals abnormal findings in patients with ATL, bronchoscopic examination should be considered to confirm whether the lesions correspond to infiltration of ATL cells.…”

Section: Discussionmentioning

confidence: 99%

Smoldering adult T-cell leukemia complicated with pneumocystis pneumonia: A case report

Kawamoto

Yamasaki

Taniwaki

et al. 2021

Respiratory Medicine Case Reports

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Adult T-cell leukemia (ATL) is a tumor of CD4-positive T cells that accompanies an infection by human T-cell lymphotropic virus (HTLV-I). ATL is classified into four types—acute, lymphomatous, chronic, and smoldering. Opportunistic infections are known to occur in patients with acute or lymphomatous type ATL; however, whether patients with chronic or smoldering ATL also have a high risk of opportunistic infections is not yet known. Herein, we report a case of pneumocystis pneumonia in a patient with smoldering ATL. He was a 64-year-old man with primary complaints of cough and dyspnea on exertion. A chest radiograph showed infiltration shadows in the left lung field. He was prescribed antibiotics for pneumonia; however, his symptoms worsened, and he developed hypoxemia. White-blood cell count was 13000/μL, and 7% of atypical lymphocytes were found in the smears of peripheral blood cells. His serum β-D glucan concentration was increased to 85.9 pg/mL, and his serum tested positive for anti–HTLV-1 antibody. Chest-computed tomography revealed diffuse ground-glass opacities in the bilateral lung fields. Pneumocystis-polymerase chain reaction performed on bronchoalveolar lavage fluid confirmed pneumocystis, but atypical lymphocytes were not detected via transbronchial lung biopsy. Therefore, he was diagnosed with pneumocystis pneumonia associated with smoldering ATL. Sulfamethoxazole-trimethoprim and corticosteroid therapies were administered to treat the pneumocystis pneumonia, and his symptoms and lung shadows improved rapidly. Thus, opportunistic infections, including pneumocystis pneumonia, may be caused by smoldering ATL. In the case of atypical lymphocyte detection in peripheral-blood smears, clinicians should consider the possibility of ATL.

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Thoracic manifestations of adult T-cell leukemia/lymphoma on chest CT: difference between clinical subtypes

Cited by 7 publications

References 18 publications

Cryobiopsy for Pneumocystis jirovecii pneumonia secondary to adult T‐cell lymphoma/leukaemia

Cryobiopsy for Pneumocystis jirovecii pneumonia secondary to adult T‐cell lymphoma/leukaemia

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

Smoldering adult T-cell leukemia complicated with pneumocystis pneumonia: A case report

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