Adult T Cell Leukemia/Lymphoma in a 56 years Old Indian Male with History of Miliary Kochs on Anti-Tubercular Therapy

Abstract

Adult T-cell leukemia/lymphoma (ATLL) is a rare T lymph proliferative disorder which is etiologically linked with human T-cell lymphotropic virus type-1 (HTLV-1). HTLV-1 is endemic in Japan, Caribbean and Africa. The highest incidence of ATLL is in Japan although sporadic cases have been reported elsewhere in the world. We describe a case of ATLL where a 56-year-old Indian male was referred to our hospital for increasing swelling on the left side of neck and thigh since last one month. Clinical examination revealed tender left cervical mass (150 mm by 90 mm) that was fixed, warm and slightly erythematous. A subcutaneous mass (40 mm by 35 mm) on the left thigh was non-tender and without erythema. Histopathological examination of the neck and thigh mass showed mixtures of intermediate and large atypical tumor cells. Immunohistochemical staining was positive for CD3, CD4 and CD8 and negative for CD29 and CD 79a, results that were consistent with T-cell lymphoma. Testing for antibody to human T-cell leukemia virus type 1 (HTLV-1) was positive.