A Case of Adult T-cell Leukemia with a Pathological Fracture.

  • Yamaguchi Tetsuo
    Department of Orthopaedic Surgery, Kitakyushu General Hospital
  • Majima Ryuzo
    Department of Orthopaedic Surgery, Kitakyushu General Hospital
  • Tsurumoto Toshiyuki
    Department of Orthopaedic Surgery, Kitakyushu General Hospital
  • Narabayashi Yoko
    Department of Orthopaedic Surgery, Kitakyushu General Hospital
  • Iwanaga Satoshi
    Department of Orthopaedic Surgery, Kitakyushu General Hospital
  • Arima Nobuyuki
    Second Department of Pathology, University of Occupational and Environmental Health, School of Medicine
  • Hirano Toru
    Department of Orthopaedic Surgery, Nagasaki University School of Medicine

Bibliographic Information

Other Title
  • 病的骨折を呈した成人T細胞白血病の1例

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Abstract

A 62 year-woman was admitted with pain in the chest, lower back and both lower extremities in January 1995. Clinical findings revealed osteolytic lesions and hypercalcemia. She sustained a subtrochanteric fracture of the left femur after a fall. We treated the fracture with an intramedullary nail. Biopsy of the osteolytic lesions around the fracture demonstrated osteitis fibrosa cystica with no surrounding tumor cells. After the operation, we demonstrated positive HTLV-1 antisera and a high level of CD4, CD4/CD8 and CD25. In June, a subcutaneous tumor appeared in the left thigh. The biopsy demonstrated a T-cell lymphoma, and we confirmed a diagnosis of ATL. Serum PTHrP was high and serum intact PTH low, suggesting that the cause of the osteolytic lesions was PTHrP originating from the ATL tumor cells.

Journal

  • Orthopedics & Traumatology

    Orthopedics & Traumatology 46 (4), 1134-1139, 1997

    West-Japanese Society of Orthopedics & Traumatology

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