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Case of adult T‐cell leukemia/lymphoma manifesting marked purpura
Author(s) -
OKADA Junna,
IMAFUKU Shinichi,
TSUJITA Jun,
MOROI Yoichi,
URABE Kazunori,
FURUE Masutaka
Publication year - 2007
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.2007.00384.x
Subject(s) - dermis , pathology , lymphoma , adult t cell leukemia/lymphoma , medicine , skin biopsy , purpura (gastropod) , leukemia , lesion , papillary dermis , biopsy , papule , biology , immunology , t cell leukemia , ecology
We present a case of a 62‐year‐old woman with marked purpura, first appearing on both legs, then spreading over the whole body, including the face. At presentation, the patient was thought to have Henoch–Schonlein purpura. However, a skin biopsy from a purpuric lesion revealed prominent infiltrations of atypical lymphocytes into the papillary dermis and marked extravasation of erythrocytes through the epidermis and upper dermis. Antibody to human T‐lymphotropic virus type 1 (HTLV‐1) was present in the serum and samples from skin lesions revealed HTLV‐1 proviral DNA integration, as well as a clonal T‐cell receptor Cβ1 gene rearrangement. We therefore diagnosed this case as adult T‐cell leukemia/lymphoma (ATL), and the purpuric lesions as ATL‐specific. Soon after the initiation of chemotherapy, these purpuric lesions began to resolve with pigmentation.