Qasim Abeer, Bhandari Sachin, Peesapati Venkata Sri Ramani, Parikh Harsh R, Baqui Aam
Internal Medicine, BronxCare Health System, Bronx, USA.
Internal Medicine, St. George's University School of Medicine, St. George's, GRD.
Cureus. 2023 Jul 1;15(7):e41264. doi: 10.7759/cureus.41264. eCollection 2023 Jul.
Adult T-cell lymphoma (ATL) is a hematological malignancy of CD4+ mature T-lymphocytes commonly associated with chronic human T-lymphotropic virus type I (HTLV-1) infection. Chronic HTLV-1 infection induces oncogenic mutations in CD4+ T-cells, leading to an acute malignant transformation of host cells. Atypically, ATL presents with dermatological and pulmonary symptoms consistent with a "smoldering" disease pattern. We present a case of a 78-year-old male patient with chronic generalized malaise, progressively worsening shortness of breath, and diffuse erythroderma, who was diagnosed with ATL secondary to chronic indolent HTLV-1 infection. We evaluate the multisystemic clinical signs associated with ATL, the comprehensive clinical investigations required to reach a conclusive diagnosis, and the options for long-term clinical management.
成人T细胞淋巴瘤(ATL)是一种CD4+成熟T淋巴细胞的血液系统恶性肿瘤,通常与慢性I型人类嗜T淋巴细胞病毒(HTLV-1)感染有关。慢性HTLV-1感染会在CD4+ T细胞中诱发致癌突变,导致宿主细胞急性恶性转化。非典型情况下,ATL会出现与“隐匿性”疾病模式相符的皮肤和肺部症状。我们报告一例78岁男性患者,其患有慢性全身不适、进行性加重的呼吸急促和弥漫性红皮病,被诊断为继发于慢性惰性HTLV-1感染的ATL。我们评估了与ATL相关的多系统临床体征、做出确定性诊断所需的全面临床检查以及长期临床管理的选择。