CLINICAL AND HISTOLOGIC SPECTRUM OF HUMAN T-CELL LYMPHOTROPIC VIRUS TYPE I-ASSOCIATED LYMPHOMA INVOLVING THE SKIN

Background: Adult T-cell leukemia/lymphoma (ATL) is associated with in fection with human T-cell lymphotropic virus type I HTLV-I). Objective : The objective was to describe the clinical, histopathologic, and imm unologic features in three patients with ATL involving the skin. Metho ds: Clinical histories and skin biopsy specimens were reviewed. Immuno phenotypic studies were performed on peripheral blood lymphocytes (thr ee patients) and on skin biopsy specimens (one patient). Results: Sero logic testing in each patient was positive for HTLV-I. Specific cutane ous lesions of ATL were diverse. Histologic features included markedly epidermotropic lymphoid infiltrates and dermal aggregates of lymphocy tes and macrophages resembling granulomas. One patient died 3 months a fter diagnosis; the other two are alive with residual lymphoma. Conclu sion: A spectrum of clinical, histologic, and immunophenotypic feature s are seen in ATL involving skin. Those cases with a chronic course ma y resemble mycosis fungoides clinically and histologically. Serologic testing for HTLV-I is recommended in all patients with cutaneous lymph oma from endemic areas and in those with other risk factors for HTLV-I infection.