ADULT T-CELL LEUKEMIA LYMPHOMA ASSOCIATED WITH NONINFECTIOUS EPITHELIOID GRANULOMA IN THE SKIN - A CLINICOPATHOLOGICAL STUDY/

Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) are infrequent ly associated with noninfectious granulomas in involved or noninvolved organs. Adult T-cell leukemia/lymphoma (ATLL) is an aggressive lympho proliferative neoplasm associated with T-lymphotropic virus type 1 (HT LV-1). We describe a case of cutaneous type ATLL, affecting mainly the skin as a maculopapular eruption, in which some skin biopsies contain ed epithelioid cell granulomas in the lymphoma cutis (ATLL) lesion. Th ese Lennert's-like epithelioid clusters were also present in lymph nod es, which showed some degree of invasion by the ATLL lymphocytes. Alth ough prognosis of ATLL is generally poor, our patient has had a less a ggressive course, with a survival time to date of 13 years. Our findin gs suggest that the presence of epithelioid granulomata in an ATLL pat ient may be a manifestation of a host response which confers some prot ection against the disease progression. To our knowledge, this is the first report of a case of ATLL with a noninfectious granuloma similar to a Lennert's lesion.