Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/10649
Title: A dyshidrosis-like variant of adult T-cell leukemia/lymphoma with clinicopathological aspects of mycosis fungoides. A case report.
Authors: Bittencourt, Achilea Candida Lisboa
Mota, Karla Oliveira
Oliveira, Rodrigo Ferreira de
Vallve, Maria de Lourdes Farre
Affilliation: Universidade Federal da Bahia. Hospital Universitário Prof. Edgard Santos. Departamento de Patologia, Medicina Interna. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório de Patologia Experimental. Salvador, BA, Brasil
Universidade Federal da Bahia. Hospital Universitário Prof. Edgard Santos. Departamento de Patologia, Medicina Interna. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório de Patologia Experimental. Salvador, BA, Brasil
Abstract: Adult T-cell leukemia/lymphoma (ATL) is an aggressive type of leukemia/lymphoma associated with the human T-cell lymphotropic virus (HTLV-I). We describe an adult male patient clinically and pathologically diagnosed as mycosis fungoides and treated with chemotherapy after which complete involution of the lesions occurred. The disease relapsed with confluent dyshidrosis-like vesicles on the palmoplantar regions, followed by disseminated vesiculopapules and associated lymphocytosis. A serological test performed at this time revealed HTLV-I infection, and a diagnosis of chronic ATL was made. Monoclonal integration of HTLV-I was detected in peripheral blood mononuclear cells by inverse long polymerase chain reaction. A skin biopsy revealed spongiosis, Pautrier abscesses, and intraepidermal vesicles with atypical lymphocytes and an infiltration of small and atypical CD4 lymphocytes in the superficial dermis. Proliferative index (Ki-67) was 70%. This is the first reported vesicular cutaneous ATL with confirmation of HTLV-I proviral integration. The delay that occurred in diagnosing ATL was due to the fact that mycosis fungoides and ATL may present the same clinical, histopathological, and immunohistochemical features.
Keywords: Adult T-cell leukemia/lymphoma,
Mycosis fungoides
HTLV-I infection
DeCS: Eczema Disidrótico/patologia
Infecções por HTLV-I/patologia
Leucemia-Linfoma de Células T do Adulto/patologia
Micose Fungoide/patologia
Neoplasias Cutâneas/patologia
Adulto
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Ciclofosfamida
Diabetes Mellitus
Diagnóstico Diferencial
Doxorrubicina
Eczema Disidrótico/virologia
Infecções por HTLV-I/complicações
Humanos
Imuno-Histoquímica
Leucemia-Linfoma de Células T do Adulto/quimioterapia
Micose Fungoide/quimioterapia
Neoplasias Cutâneas/quimioterapia
Issue Date: 2009
Publisher: Lippincott Williams & Wilkins
Citation: BITTENCOURT, A. C. L. et al. A dyshidrosis-like variant of adult T-cell leukemia/lymphoma with clinicopathological aspects of mycosis fungoides. A case report. American Journal of Dermatopathology, v. 31, n. 8, p. 834-837, 2009.
ISSN: 1533-0311
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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