Résumé
Abstract Hodgkin-like ATLL is a rare variant of adult T-cell leukemia/lymphoma (ATLL), a disease caused by human T-cell lymphotropic virus type-1 (HTLV-1). At admission, a 46-year-old female presented with lymphadenomegaly, lymphocytosis, slight elevation of LDH blood level, and acid-alcohol resistant bacilli in sputum and was being treated for pulmonary tuberculosis (Tb). She had lymphocytosis in the previous 20 months. Serology for HTLV-1 was positive. Lymph node was infiltrated by medium-sized lymphocytes with scattered Hodgkin and Reed-Sternberg-like cells CD30+, CS1-4+, and CD79a+. Background cells were CD4+ and CD25+. A clinical diagnosis of favorable chronic ATLL was given. She was treated with chemotherapy but later progressed to acute ATLL and ultimately died. Hodgkin-like ATLL should be considered in the histological differential diagnosis with Hodgkin lymphoma since treatment and prognosis of these diseases are distinct. It is also important to search for HTLV-1 infection in patients with unexplained prolonged lymphocytosis.
Sujets)
Humains , Femelle , Adulte d'âge moyen , Maladie de Hodgkin/anatomopathologie , Infections à HTLV-I/anatomopathologie , Leucémie-lymphome à cellules T de l'adulte/anatomopathologie , Hyperlymphocytose/anatomopathologie , Biopsie , Test ELISA , Maladie de Hodgkin/virologie , Virus T-lymphotrope humain de type 1/isolement et purification , Leucémie-lymphome à cellules T de l'adulte/virologie , Issue fatale , Hyperlymphocytose/virologie , Noeuds lymphatiques/anatomopathologieRésumé
Methylenetetrahydrofolate reductase (MTHFR: EC 1.5.1.20) polymorphisms are associated to acute lymphoid leukemia in different populations. We used the polymerase chain reaction and the restriction fragment length polymorphism method (PCR-RFLP) to investigate MTHFR C677T and A1298C polymorphism frequencies in 67 patients with chronic myeloid leukemia (CML), 27 with acute myeloid leukemia FAB subtype M3 (AML-M3) and 100 apparently healthy controls. The MTHFR mutant allele frequencies were as follows: CML = 17.2 percent for C677T, 21.6 percent for A1298C; AML-M3 = 22.2 percent for C677T, 24.1 percent for A1298C; and controls = 20.5 percent for C677T, 21 percent for A1298C. Taken together, our results provide evidence that MTHFR polymorphisms have no influence on the development of CML or AML-M3.