Dosaka N, Tanaka T, Miyachi Y, Imamura S, Kakizuka A
Department of Dermatology, Faculty of Medicine, Kyoto University, Japan.
J Invest Dermatol. 1991 Feb;96(2):196-200. doi: 10.1111/1523-1747.ep12461033.
The various clinical features of adult T-cell leukemia/lymphoma (ATL) are frequently accompanied by skin eruptions. Recently, a cutaneous type of ATL has been proposed by clinical studies. We analyzed the viral integration of human T-cell leukemia virus-I (HTLV-I) and monoclonal rearrangement of T-cell receptor (TCR) gene in blood lymphocytes and the cutaneous infiltrated cells of nine ATL patients with various clinical features and skin eruptions. We classified them by the results of Southern blot analysis and propose a cutaneous-type ATL accordingly. In two of them, we could detect the monoclonal integration of HTLV-I and T-cell monoclonality only in the skin but not in the peripheral lymphocytes. We also demonstrated the time course study in one patient. Clinicians should be aware of the HTLV-I positive cutaneous T cell lymphoma that can be named cutaneous-type ATL. Examination of viral integration and T-cell monoclonality in skin lesions is required to make an exact diagnosis of cutaneous ATL.
成人T细胞白血病/淋巴瘤（ATL）的各种临床特征常伴有皮肤疹。最近，临床研究提出了一种皮肤型ATL。我们分析了9例具有各种临床特征和皮肤疹的ATL患者血液淋巴细胞及皮肤浸润细胞中人T细胞白血病病毒I型（HTLV-I）的病毒整合及T细胞受体（TCR）基因的单克隆重排。我们根据Southern印迹分析结果对其进行分类，并据此提出一种皮肤型ATL。其中2例患者，仅在皮肤中可检测到HTLV-I的单克隆整合及T细胞单克隆性，而在外周淋巴细胞中未检测到。我们还对1例患者进行了时间进程研究。临床医生应意识到HTLV-I阳性皮肤T细胞淋巴瘤可称为皮肤型ATL。为准确诊断皮肤型ATL，需要检查皮肤病变中的病毒整合及T细胞单克隆性。
