VARIOLIFORM MUCOSAL POLYPOID LESIONS IN INTESTINAL-TRACT IN A PATIENTWITH ADULT T-CELL LEUKEMIA

We describe a case of adult T-cell leukemia (ATL) with intestinal infi ltration. In the early clinical stage, the endoscopic findings for the intestine were similar to those of amebic enterocolitis, i.e., variol iform mucosal polypoid lesions, and amebic cyst was detected with stoo l examination. Although no specific pathological factor could be ident ified on biopsy, the patient was treated for amebiasis as a diagnostic therapy. The findings of varioliform mucosal polypoid lesions were de tected in the duodenum on endoscopic examination, but the lesions even tually disappeared during the treatment for amebiasis. We then suspect ed lymphoma partially masked by the amebiasis. Immunological staining of a specimen of the colonic mucosa revealed T cell invasion and South ern blotting demonstrated adult T-cell leukemia provirus invasion. Thu s, ATL cell infiltration of the intestinal tract was confirmed. It is suggested that systemic disease should also be considered when varioli form mucosal polypoid lesions are found on colonoscopic examination.