A 65-year-old male patient complained of progressive nasal obstruction. Phymata with ulceration were found in the left nasal cavity and the right upper pharynx. No enlargement of superficial lymph nodes nor hepatosplenomegaly was found. In biopsy of the phymate, a high degree of necrosis was observed with diffuse cellular infiltration mainly by abnormal lymphocytic cells and also by histiocytes, plasma cells and neutrophils: the abnormal lymphocytic cells showed an E-rosette formation. The patient was consequently diagnosed as malignant lymphoma with diffuse T cell-type. His WBC count was 4,600/mm3, about 0.5% were abnormally indented cells. This patient and his wife had positive anti-ATLA antibodies. His phymata disappeared almost completely by a combination therapy with VEPA and Co irradiation. ATL is known to develop various types of diseases: there might have been ATL which originated from the nasal cavity exhibiting a clinical picture of progressive necrotizing rhinitis.
