Adult T-cell Leukemia-Lymphoma

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 Adult T-cell leukemia-lymphoma (ATLL) is a lymphoproliferative disease of malignant T-cells. It is associated with infection by human T-cell leukemia virus, a retrovirus.

ATLL has its highest incidence in people of Japanese, West Indian, and African American origin. In Japan ATLL tends to be a disease of the elderly, but in the African American population it appears mostly in younger individuals.

Patients with ATLL may present with lymphadenopathy, hepatomegaly, splenomegaly, or skin abnormalities.

Lytic lesions and hypercalcemia are common. Peripheral blood smears from ATLL usually will show abnormal T-lymphocytes. These cells have deeply-lobulated nuclei, a high nucleocytoplasmic ratio, clumped chromatin and inapparent nucleoli. These cells usually are positive for CD4, a marker for mature helper T cells. Other blood findings include an elevated white cell count, and occasionally anemia.

Unlike most leukemias, bone marrow infiltration is not always present in adult T-cell leukemia-lymphoma. Lymph nodes are, however, widely affected.

 

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