Inoue Y, Fujii T, Ohtsubo T, Mori N, Ishino T, Hisano H, Kaku M, Koga H, Kohno S, Hara K
Department of Internal Medicine, Hokusho Central Hospital.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Aug;32(8):778-84.
A 46-year-old female was admitted to our hospital on December 1991 for further examination of an abnormal shadow on chest X-ray. A huge mass in the upper mediastinum and a thin-walled cavitary lesion in the right upper lobe were found by chest radiography and computed tomography. On March 2, 1992, surgical resection was performed with pathological diagnosis of thymoma for the mediastinal mass and pulmonary cryptococcosis for the cavitary lesion. Although ATL cells were not found in the peripheral blood, anti-HTLV-1 antibody was found to be positive. Natural killer cell activity was lower than normal control and other tests of humoral and cell-mediated immunity were normal. Histological examination of the specimens obtained from the thymoma revealed lymphocytic predominance without atypical cells such as ATL cells, but with integration of HTLV-1 proviral DNA. There seemed to be a causal relationship between HTLV-1 carrier state and thymoma. Since there are no reported cases of HTLV-1 carrier associated with pulmonary cryptococcosis and thymoma, we report the first case with a review of the literature.
一名46岁女性于1991年12月入院，以便对胸部X光片上的异常阴影进行进一步检查。胸部X光和计算机断层扫描发现上纵隔有一个巨大肿块，右上叶有一个薄壁空洞性病变。1992年3月2日进行了手术切除，纵隔肿块的病理诊断为胸腺瘤，空洞性病变的病理诊断为肺隐球菌病。尽管外周血中未发现成人T细胞白血病（ATL）细胞，但抗人类嗜T淋巴细胞病毒1型（HTLV-1）抗体呈阳性。自然杀伤细胞活性低于正常对照，体液免疫和细胞介导免疫的其他检测结果正常。对胸腺瘤标本进行组织学检查，结果显示以淋巴细胞为主，未见ATL细胞等非典型细胞，但存在HTLV-1前病毒DNA整合。HTLV-1携带状态与胸腺瘤之间似乎存在因果关系。由于尚无HTLV-1携带者合并肺隐球菌病和胸腺瘤的报道病例，我们报道首例病例并复习相关文献。
