Abstract
Conflicts of interest: none declared. Madam, The previous World Health Organization’s (WHO) classification of malignant lymphomas defined CD4+/CD56+ blastic natural killer (NK)‐cell lymphoma arising from NK‐cell precursors. However, recent studies suggest a plasmacytoid dendritic cell precursor.1, 2 Therefore, the new WHO classification has been recently changed to ‘CD4+/CD56+ haematodermic neoplasm’. CD4+/CD56+ haematodermic neoplasm is a clinically aggressive neoplasm with a median survival of 14 months.3 Human T‐cell leukaemia virus type 1 (HTLV‐1) has been classically associated with adult T‐cell leukaemia/lymphoma (ATLL). A recent review of PubMed for key terms ‘NK‐lymphoma’, ‘HTLV‐1’ and ‘CD4+ CD56+ lymphoma’ did not reveal any cases of CD4+/CD56+ blastic NK‐cell lymphoma in association with HTLV‐1 infection. The incidence of HTLV‐1 infection is increased in endemic areas such as central Africa, the Caribbean islands, Fukuoka, Japan and South America.4, 5 It has been well documented that infectious agents such as Epstein–Barr virus (EBV) and HTLV‐1 are associated with lymphomas. Classically, EBV infection is associated with nasal‐type NK lymphomas.6 Currently there is no infectious aetiology associated with CD4+/CD56+ haematodermic neoplasm.
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