HUMAN T-LYMPHOTROPIC VIRUS TYPE-I DNA IN SPINAL-CORD OF TROPICAL SPASTIC PARAPARESIS WITH CONCOMITANT HUMAN T-LYMPHOTROPIC VIRUS TYPE-I NEGATIVE HODGKINS-DISEASE

We studied a 58-year-old black woman from Barbados who simultaneously developed myelopathy and lymphoma with human T-lymphotropic virus type I (HTLV-I) antibodies in serum and cerebrospinal fluid and died 3 yea rs after onset. Neuropathological examination showed typical tropical spastic paraparesis (TSP). The polymerase chain reaction (PCR) demolzs trated defective proviral genome retaining the HTLV-I pX and env regio ns in thoracic spinal cord, the level most severely affected. Defectiv e HTLV-I in the nervous system retaining the pX region may be relevant to pathogenesis because circulating CD8+ cytotoxic lymphocytes specif ic for HTLV-I pX occur in HTLV-I myelopathy. This patient's lymph node biopsy specimen was consistent with Hodgkin's disease (HD), nodular s clerosis subtype, of B-cell origin. The PCR in the paraffin-embedded l ymph node involved by HC, failed to amplify HTLV-I poviral sequences. Complete HTLV-I proviral amplification was obtained in paraffin-embedd ed lymph nodes from positive controls (adult T-cell leukemia). To our knowledge the association of TSP and HD has not been reported previous ly. Despite claims that HD may be associated with HTLV-I, we demonstra ted absence of HTLV-I-infected T cells in the lymphoid infiltrate of H D in this case, positive HTLV-I serology notwithstanding.