ABSTRACT
We experienced a case of adult T cell leukemia/lymphoma (ATLL) in a 48-year-old Korean female, who has never been abroad since birth and no history of blood transfusion. The patient had hypercalcemia and multiple lymphadenopathy. Histopathologic study of left cervical lymph node (LN) and bone marrow (BM) revealed that infiltrates of malignant lymphoid cells were composed of small, medium and large cells with pleomorphic nuclei. Smears of peripheral blood (PB) showed lymphopenia (16%) with the appearance of a few atypical lymphoid cells (less than 2%), but not the typical clover leaf cells seen in ATLL. Immunophenotypic study of LN and BM revealed T cell phenotype. PB showed increased CD4+ T cell (T(H), CD3/CD4+, 57%) and decreased CD8+ T cell counts (T(S), CD3/CD8+, 6.7%). The sera of the patient and her family were reactive for HTLV-I antibody. The specific sequences of pol, env, and tax of HTLV-I DNA were detected in the lymphoma cells and peripheral blood mononuclear cells (PBMC) using polymerase chain reaction. Ultrastructural examination of PBMC confirmed numerous type c virus particles in extracellular space. This case was an acute type of ATLL without overt leukemic features in PB. Despite chemotherapy and intensive conservative treatment, she died 3 months after admission.
Subject(s)
Female , Humans , Biopsy , Bone Marrow/pathology , DNA, Viral/analysis , Fatal Outcome , Flow Cytometry , Gene Products, env/genetics , Gene Products, pol/genetics , Gene Products, tax/genetics , Deltaretrovirus Infections/pathology , Human T-lymphotropic virus 1 , Hypercalcemia/virology , Hypercalcemia/pathology , Immunophenotyping , Korea , Leukemia, T-Cell/virology , Leukemia, T-Cell/pathology , Leukemia, T-Cell/immunology , Lymph Nodes/pathology , Lymphopenia/virology , Lymphopenia/pathology , Lymphopenia/immunology , Microscopy, Electron , Middle Aged , T-Lymphocytes/virology , T-Lymphocytes/ultrastructure , T-Lymphocytes/pathologyABSTRACT
Se presenta un modelo de linfoma espontáneo en ratones BALB/c que por sus características es apropiado para el estudio de las interacciones entre el tumor y el sistema inmune. La caracterización de las células tumorales se realizó por FACS hecho que permitió determinar que el tumor está constituído por linfocitos T que no expresan proteínas virales gp70 en su membrana y que llevan marcadores de células colaboradoras (CD4) y supresoras (CD8). Además, expresan el receptor para IL-2 y antígenos del complejo mayor de histocompatibilidad de clase I pero no de clase II. No se encuentran anticuerpos en el suero ni en el líquido ascítico de los ratones portadores del tumor (transplante síngeneico); se pudo determinar en estos fluídos la presencia de un factor supresor que inhibió la proliferación de las células tumorales in vitro sí como la respuesta linfoproliferativa a Concavalina A de esplenocitos normales. Los resultados permiten concluir que este modelo experimental puede ser utilizado para el estudio y caracterización de citoquinas que podrían ser responsables del estado de inmunosupresión que se observa en ciertos pacientes con cáncer