Furukawa Y, Tanaka K, Hasuike T, Hirai M, Misu K, Ohira H, Ohta K, Yasui Y, Nakao Y, Inoue T
Department of Laboratory Medicine, Osaka City University Medical School.
Rinsho Byori. 1991 Aug;39(8):886-90.
A 52-year-old man, who came from Kagoshima prefecture, was hospitalized because of lumbago and lymphadenopathy. On admission, mild anemia and leukocytosis with atypical lymphoid cells were seen in the peripheral blood. Flow cytometry of the abnormal lymphocytes showed that they expressed CD4, and CD25, but not CD8. Anti HTLV I antibody was expressed in the serum. Atypical lymphoid cells had proviral DNA with restriction enzyme EcoRI. Lymphnode biopsy was performed and the specimens of lymphnode showed diffuse infiltration of abnormal lymphocytes. So we diagnosed Adult T-cell leukemia lymphoma. The patient's serum calcium level was increased, so he lost consciousness and became oliguric and developed acute renal failure. Hemodialysis was required to control azotemia. During the time of hemodialysis, cardiac arrest was occurred and he died. Autopsy confirmed the presence of a metastatic calcification in various organs, such as myocardium, alveolar septa of the lungs, and gastric mucosa. A metastatic calcinosis was found in the myocardium, which was thought to be the cause of his heart failure. But at the ATLL cells didn't infiltrate in the myocardium. Calcinosis was a significant complication of neoplastic disease in these patients and contributed to morbidity and mortality.
一名来自鹿儿岛县的52岁男性因腰痛和淋巴结病入院。入院时，外周血中可见轻度贫血和伴有非典型淋巴细胞的白细胞增多。异常淋巴细胞的流式细胞术显示它们表达CD4和CD25，但不表达CD8。血清中表达抗HTLV I抗体。非典型淋巴细胞具有经限制性内切酶EcoRI处理的前病毒DNA。进行了淋巴结活检，淋巴结标本显示异常淋巴细胞弥漫浸润。因此，我们诊断为成人T细胞白血病淋巴瘤。患者血清钙水平升高，随后失去意识，尿量减少并发展为急性肾衰竭。需要进行血液透析以控制氮质血症。在血液透析期间，发生心脏骤停并死亡。尸检证实多个器官存在转移性钙化，如心肌、肺的肺泡间隔和胃黏膜。在心肌中发现转移性钙质沉着，被认为是其心力衰竭的原因。但成人T细胞白血病淋巴瘤细胞并未浸润心肌。钙质沉着是这些患者肿瘤性疾病的一个重要并发症，可导致发病和死亡。
