HTLV1-ASSOCIATED ADULT T-CELL LEUKEMIA-LY MPHOMA REVEALED BY A LYMPHOMATOUS MENINGORADICULOPATHY

A case of HILV1-associated adult T cell leukaemia/lymphoma (ATLL) in a 21-year olf African woman is reported. The patient presented with lym phomatous meningoradiculopathy. The usual clinical features of ATLL we re absent. Lumbar MRI showed a pial enhancement by DTPA-gadolinium of the conus medullaris which extended to the proximal cauda equina. Unde r systemic chemotherapy coupled with intrathecal chemotherapy the pati ent progressively improved, and at the second MRI examination complete disappearance of the lumbar enhancement was observed. MRI of the brai n using axial and coronal T2-weighted sequences detected multifocal le sions of high-intensity signal in the subcortical white matter. ATLL i s unusual in people of African origin. The ATLL-strongyloides infestat ion association has previously been reported, suggesting that parasiti c infestation may be an important co-factor leading to the development of ATLL.