Taguchi H, Takaoka K, Nasuhara Y, Kawakami Y
Department of Respiratory Medicine, Nikko Memorial Hospital, Muroan, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Dec;30(12):2134-8.
Three cases of chronic respiratory tract lesions as a complication of adult T-cell leukemia (ATL) are reported. Case 1 was seropositive for HTLV-1 on recent examination following treatment of bronchiolitis. Chest radiograph revealed over inflation of the lungs and bilateral diffuse small nodular shadows. Pulmonary function test resulted hypoxemia and mixed ventilation disorder. Pathological examination confirmed lymphocytic infiltration of the bronchiolar wall. Both clinically and pathologically the patient was diagnosed as having diffuse panbronchiolitis (DPB). Therefore, this case was considered to be the bronchiolar type of HTLV-1 associated bronchiolo-alveolar disorder (HABA). The other two cases with smoldering or chronic ATL presented with long-standing symptoms of productive cough due to chronic respiratory lesions. We consider that all three cases had HTLV-1 virus associated pulmonary lesions, but with different clinical and pathological presentations. Among 12 cases of bronchiolitis experienced at our hospital, three were positive for HTLV-1.
报告了3例成人T细胞白血病（ATL）并发症所致慢性呼吸道病变。病例1在细支气管炎治疗后的近期检查中HTLV-1血清学呈阳性。胸部X线片显示肺部过度充气和双侧弥漫性小结节阴影。肺功能测试结果为低氧血症和混合性通气障碍。病理检查证实细支气管壁有淋巴细胞浸润。临床和病理上该患者均被诊断为弥漫性泛细支气管炎（DPB）。因此，该病例被认为是HTLV-1相关细支气管肺泡疾病（HABA）的细支气管型。另外2例冒烟型或慢性ATL患者因慢性呼吸道病变出现长期的咳痰症状。我们认为所有这3例均有HTLV-1病毒相关的肺部病变，但临床和病理表现不同。在我院经历的12例细支气管炎病例中，3例HTLV-1呈阳性。
