An Autopsy Case of Adult T-cell Leukemia with Chromosome Abnormality and OKT4 and OKT8 Subsets, Complicated with Intestinal Involvements

Abstract

A 65-year-old man born in Nagasaki prefecture was admitted to the hospital because of general fatigue. The leukocyte count in the peripheral blood was 50,100/cmm, with 83% atypical lymphocytes showing pleomorphism and deeply indented or convoluted nuclei.
T cell subset analysis was done with monoclonal antibodies. Leukemic cell had T cell markers (OKT3: 51.1%, OKT4: 92.3%, OKT8: 92.9%, OK-Ial: 2.1%, OKT6: 0.6%, OKT11: 92.4%, OKT9: 35.1%, OKT10: 82.4%, Leu 3a: 74.6%, Leu 2a: 91.4%, J5: 2.2%, B1: 2.2%, and B2: 1.7%). The leukemic cells had the both phenotypes of helper/inducer and suppressor/cytotoxic.
The chromosome abnormality, karyotype 47, XY, 18P⁺, +1P^-/46, XY, was also found.
Postmortem examination showed extensive infiltration of leukemic cells in the gastrointestinal tract (tongue. esophagus, stomach, and duodenum), generalized lymph nodes, bone marrow, liver, spleen, pancreas, lung, and kidney.
The clinical and immunological characteristics were reported.