Multiple tiny granulomatous lesions with eosinophils in a patient with smoldering‐type adult T‐cell leukaemia: The possibility of a new type of bronchioloalveolopathy

We herein describe the first case, to our knowledge, of pulmonary lesions characterized by necrotizing granuloma formation with eosinophils, in a patient with smoldering‐type adult T‐cell leukaemia. A 74‐year‐old man, diagnosed with smoldering‐type adult T‐cell leukaemia 1 year previously, was admitted due to repeated pyrexia and concurrent identification of diffuse small pulmonary nodules. A surgical lung biopsy specimen revealed inflammatory nodular lesions measuring up to 3 mm in size, which contained necrotizing and non‐necrotizing granulomas, intraluminar organization and eosinophils, and were of unknown aetiology. The patient's condition, including the radiological findings, improved gradually without any treatment. This case suggests the possibility of a new type of human T‐lymphotropic virus type‐1 associated bronchioloalveolar disorder.