A Case of Adult T-cell Leukemia/Lymphoma with Erythroderma Caused by Graft versus Host Disease Reaction

YAMAMOTO Mayuko, AOKI Natsuko, NAKAJIMA Kimiko, SANO Shigetoshi

doi:10.2336/nishinihonhifu.78.639

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組織学的 GVHD 型反応により紅皮症を呈した ATLL の1例
症例組織学的GVHD型反応により紅皮症を呈したATLLの1例
ショウレイソシキガクテキ GVHDガタハンノウニヨリベニヒショウオテイシタ ATLL ノ 1レイ

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Abstract

<p>A 78-year-old woman presented with a 3-month history of febrile erythroderma. Physical examination revealed diffuse erythema with scale over her whole body including the scalp and face. She also showed swelling of the axillary lymph nodes. Serum anti-HTLV-1-antibody was present. Histological examination of a biopsy specimen showed an infiltration of CD25- positive atypical lymphocytes in the epidermis, including numerous CD8-positive lymphocytes. Furthermore, there were vacuolar changes in the basal epidermis and scattered apoptotic keratinocytes, resembling a graft versus host disease (GVHD) reaction. A PCR analysis of the skin biopsy specimen revealed a monoclonal HTLV-1 proviral load, although a Southern blot analysis failed to prove the monoclonality. Adult T cell leukemia/lymphoma (ATLL) cells in the peripheral blood were never observed during the clinical course. It is considered that an intense response of the patient's cytotoxic T lymphocytes to the ATLL cells inhibited their proliferation and led to a GVHD-like reaction, resulting in erythroderma without a preceding ATLL specific skin eruptions.</p>

Journal

Nishi Nihon Hifuka

Nishi Nihon Hifuka 78 (6), 639-643, 2016

Western Division of Japanese Dermatological Association

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