ADULT T-CELL LEUKEMIA LYMPHOMA WITH MASSIVE INVOLVEMENT OF CARDIAC-MUSCLE AND VALVES/

An autopsy case of a 58-year-old woman with massive cardiac involvemen t of adult T cell leukemia/lymphoma (ATLL) is reported. She developed cardiac failure due to aortic and mitral regurgitation with cardiac in filtration of ATLL cells, and underwent replacement of both aortic and mitral valves. Studies of the cut-surfaces revealed diffuse thickenin g of the subendocardial wall of the left chamber with widespread whiti sh-brown tumor infiltrates. In the regions surrounding the replaced ao rtic and mitral valves there was also massive tumor cell infiltration. The tumor cells infiltrating the cardiac muscle wall were T cell in o rigin and exhibited Leu-3a (CD4)-positive immunoreaction. Ultrastructu rally, tumor cells contained markedly indented nuclei and some were at tached directly to the muscle cells, These findings suggest that this was an unusual form of ATLL with widespread involvement of the heart.