Tong Guo-Xia, Hernandez Osvaldo, Yee Herman T, Zheng Shyun-Hua, Yang Grace C H
Department of Pathology, New York University School of Medicine, New York, New York 10016, USA.
Diagn Cytopathol. 2004 Nov;31(5):333-7. doi: 10.1002/dc.20121.
A 48-yr-old black woman with a history of blood transfusions for menorrhagia secondary to uterine fibroids but no known Caribbean association presented with a 6-wk history of a rapidly enlarging right parotid mass. At the time of presentation, she could not close her right eye. An aspiration biopsy showed small, medium, and large lymphoma cells with angulated nuclei, red macronucleoli, and basophilic cytoplasm with fine vacuoles. Flow cytometry indicated a (CD25(+)/CD7(-)) T-cell lineage, suggesting an human T-lymphotropic virus (HTLV) 1-related T-cell leukemia/lymphoma, which was confirmed by polymerase chain reaction (PCR)-based amplification on DNA extracted from fresh tissue with specific oligonucleotide primers for HTLV-1 DNA sequence. Histology showed interstitial infiltration and destruction of the parotid parenchyma by lymphoma cells without involvement of adjacent lymph nodes. Total body CT scan and magnetic resonance imaging (MRI) studies were negative for lymphadenopathy but showed liver metastasis. To our knowledge, this is the first reported case of HTLV-1-related primary parotid lymphoma as the initial presentation of adult T-cell leukemia/lymphoma.
一名48岁的黑人女性，有因子宫肌瘤继发月经过多而输血的病史，但无已知的加勒比地区关联，出现了一个6周来迅速增大的右侧腮腺肿块。就诊时，她右眼无法闭合。穿刺活检显示有小、中、大淋巴瘤细胞，核呈角形，有红色大核仁，嗜碱性细胞质有细小空泡。流式细胞术显示为（CD25(+)/CD7(-)）T细胞谱系，提示与人嗜T淋巴细胞病毒（HTLV）1相关的T细胞白血病/淋巴瘤，通过基于聚合酶链反应（PCR）的扩增，使用针对HTLV-1 DNA序列的特异性寡核苷酸引物，从新鲜组织中提取的DNA证实了这一点。组织学显示淋巴瘤细胞间质浸润并破坏腮腺实质，未累及相邻淋巴结。全身CT扫描和磁共振成像（MRI）检查未发现淋巴结病，但显示有肝转移。据我们所知，这是首例报道的以HTLV-1相关原发性腮腺淋巴瘤作为成人T细胞白血病/淋巴瘤初始表现的病例。
