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Adult T‐cell leukemia predominantly involving exocrine glands
Author(s) -
Obama Kosuke,
Saito Mineki,
Higuchi Itsuro,
Tara Mitsutoshi,
Niina Kiyoshige,
Osame Mitsuhiro
Publication year - 2004
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2004.00309.x
Subject(s) - t cell receptor , pathology , parotid gland , immunohistochemistry , exocrine gland , biology , leukemia , t cell leukemia , salivary gland , immunophenotyping , antigen , t cell , medicine , immunology , endocrinology , immune system , secretion
Objectives : We describe a rare case of adult T‐cell leukemia (ATL) presenting with dry mouth and swelling of bilateral parotid and submandibular glands. The unusual involvement of these exocrine glands by malignant cells prompted us to conduct a detail characterization of these infiltrating and circulating leukemic T cells, which may provide insight to the pathogenesis of exocrine involvement in ATL. Methods : Immunophenotyping of peripheral ATL cells and microscopic examinations of various organs prepared by autopsy were performed. Analysis of the repertoire of T‐cell receptor (TCR) of parotid gland‐infiltrating ATL cells using molecular and immunohistochemical examinations were also performed. Results : Microscopic examinations of various organs prepared by autopsy revealed the predominant and specific exocrine gland infiltration of ATL cells. Reverse transcription‐polymerase chain reaction (RT‐PCR) followed by both TCR spectratyping and complementary determining region (CDR)‐3 sequencing analysis of TCR V β of parotid gland‐infiltrating T cells revealed a relatively restricted but not single usage of TCR V β . Immunohistochemical analyses of parotid gland specimens detected only a small number of TCR V α β ‐positive cells in parotid gland‐infiltrating ATL cells. Conclusions : The predominant infiltration of ATL cells in exocrine glands implied that these T cells recognized exocrine gland‐specific antigen. However, the absence of both TCR V β mRNA transcripts and TCR V α β protein expression in most ATL cells suggested that antigen recognition via TCR may not have played a major role in adhesion and subsequent infiltration into the exocrine glands in this patient. These results provide important background information to further elucidate the pathogenesis of exocrine gland‐specific inflammation.