GASTRIC-LESIONS IN 76 PATIENTS WITH ADULT T-CELL LEUKEMIA LYMPHOMA - ENDOSCOPIC EVALUATION/

BACKGROUND. Adult T-cell leukemia/lymphoma (ATLL) is caused by human T -lymphotropic virus type I. Gastric lesions in ATLL have not been desc ribed precisely, whereas the clinical features of ATLL have been well documented. The goal of the present study was to review gastric lesion s, including gastric involvement, of patients with ATLL who were admit ted to our hospital. METHODS, Endoscopic examination of the upper gast rointestinal tract was performed on 76 of 110 patients who were admitt ed to our hospital between 1981 and 1994. Gastric involvement was diag nosed by histologic examination of biopsy specimens of gastric lesions . Types of gastric lesions, histologic features, and survival periods in patients with ATLL were summarized. RESULTS, Of the 76 patients wit h ATLL who underwent an endoscopic examination, 23 had gastric involve ment (30.3%). Twenty-seven patients had other gastric lesions: 10 with peptic ulcers (13.2%), 8 with gastric erosions (10.5%), 3 with submuc osal tumors (3.9%), 2 with hyperplastic polyps (2.6%), 1 with gastric adenoma (1.3%), and 3 with gastric carcinomas (3.9%). The most frequen t endoscopic con figuration of gastric involvement with ATLL was the d iffuse type with ulceration, and the most common histology was large c ell type. Among those with the acute type ATLL, the survival period of those patients with gastric involvement was less than that of the pat ients without gastric involvement. In contrast, the survival period fo r lymphoma type ATLL did not differ among the groups regardless of gas tric involvement. CONCLUSIONS, This study demonstrated that 30.3% of p atients with ATLL had gastric involvement and 13.2% had peptic ulcers. Gastric involvement of ATLL was one of the prognostic factors in acut e type ATLL, whereas it had no influence on the prognosis of lymphoma type ATLL. (C) 1996 American Cancer Society.