Yamaguchi T, Ohshima K, Karube K, Tutiya T, Kawano R, Suefuji H, Shimizu A, Nakayama J, Suzumiya J, Moroi Y, Urabe K, Furue M, Koga T, Kikuchi M
Department of Pathology, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0189, Japan.
Br J Dermatol. 2005 Jan;152(1):76-81. doi: 10.1111/j.1365-2133.2004.06274.x.
Adult T-cell leukaemia/lymphoma (ATLL) is a human malignancy associated with human T-cell leukaemia virus type I (HTLV-I). ATLL frequently involves the skin.
To correlate the clinicopathological features and prognosis in patients with ATLL and cutaneous lesions.
We examined the HTLV-I proviral state and the clinicopathological features of the cutaneous lesions in 80 patients with serum anti-ATL antibody, to clarify the correlation between macroscopic/histopathological findings and prognosis. Southern blot analysis was performed in all cases to detect monoclonal HTLV-I proviral DNA integration.
The cutaneous lesions of 46 patients were positive for proviral DNA integration. The median survival time of patients with monoclonal proviral DNA integration in cutaneous lesions was 14 months, which was markedly shorter than that of patients negative for proviral DNA integration (72 months). Of the 46 patients with proviral DNA, 21 had solitary or multiple red nodules (including three with subcutaneous induration), eight had multiple red papules and 17 had erythema. Patients with papules and nodules had poorer prognosis than those with erythema. Histopathologically, the prognosis was poorer in patients with nodular or diffuse infiltration of medium-sized to large lymphoma cells, compared with those with perivascular infiltration of small to medium-sized lymphoma cells.
Our results show a close correlation between clinicopathological features of HTLV-I-associated cutaneous lesions and prognosis.
成人T细胞白血病/淋巴瘤（ATLL）是一种与I型人类T细胞白血病病毒（HTLV-I）相关的人类恶性肿瘤。ATLL常累及皮肤。
探讨ATLL合并皮肤损害患者的临床病理特征与预后的相关性。
我们检测了80例血清抗ATL抗体患者的HTLV-I前病毒状态及皮肤损害的临床病理特征，以阐明宏观/组织病理学表现与预后之间的相关性。所有病例均进行Southern印迹分析以检测单克隆HTLV-I前病毒DNA整合。
46例患者的皮肤损害前病毒DNA整合呈阳性。皮肤损害中单克隆前病毒DNA整合患者的中位生存时间为14个月，明显短于前病毒DNA整合阴性患者（72个月）。在46例前病毒DNA阳性的患者中，21例有单个或多个红色结节（包括3例有皮下硬结），8例有多个红色丘疹，17例有红斑。丘疹和结节患者的预后比红斑患者差。组织病理学上，中等大小至大淋巴瘤细胞呈结节状或弥漫性浸润的患者预后比小至中等大小淋巴瘤细胞呈血管周围浸润的患者差。
我们的结果表明HTLV-I相关皮肤损害的临床病理特征与预后密切相关。
