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- W3205025399 abstract "Introduction: Adult T cell leukemia/lymphoma (ATL) is a peripheral T cell malignancy caused by human T-lymphotropic virus type-1 (HTLV-1) infection. The skin can affect in approximately half of ATL patients. Here we present a case of ATL presented skin lesions as the initial manifestation and transformed into the acute subtype. Case presentation: A 62-year-old man presented with a 5-year history of reddish plaques and tumors on the trunk and extremities. He has been misdiagnosed as mycosis fungoides (MF) based on the histopathological features of skin biopsy. Further laboratory examinations including positive expression of CD25 by immunohistochemistry, positive for anti-HTLV-1 antibody and HTLV-1 proviral DNA by serological and polymerase chain reaction test, respectively. A diagnosis of smoldering subtype of ATL was made. The skin lesions subsided with the treatment of subcutaneous injections of interferon and topical nitrogen mustard. However, the disease advanced 8 months later, transformed into the acute subtype, and died 2 weeks later. Discussion: ATL was divided into acute, chronic, lymphomatous, and smoldering subtypes based on clinical and hematoserological features and prognostic factors correlated with survival. Therefore, correct diagnosis and close follow-up are warranted. Patients with ATL often present skin lesions with heterogeneous clinical and pathological features which mimic MF. The essential to distinguish ATL from MF is that HTLV-1 serology and genomic analysis are all positive in the former. Conclusion: We presented a rare transformed clinical course of ATL. Given the poor prognosis of ATL, when identifying a patient of MF shows atypical manifestation both clinically and histopathologically, etiological examination of HTLV-1 is imperative to rule out the diagnosis of ATL." @default.
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- W3205025399 date "2021-10-12" @default.
- W3205025399 modified "2023-09-26" @default.
- W3205025399 title "Adult T-cell leukemia/lymphoma with skin lesions as the initial manifestation and transformed into an acute subtype" @default.
- W3205025399 doi "https://doi.org/10.1097/jd9.0000000000000196" @default.
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