Abstract
A 26-year-old male, born in Hokkaido, Japan, was admitted to the hospital because of bilateral diffuse interstitial shadows in the chest radiogram. Atypical lymphocytes were found in the peripheral blood and in the bronchoalveolar lavage fluid (BALF). Antibody against ATL-associated antigen (ATLA) was positive in his serum. ATLA was expressed in the lymphocytes. Human T-cell leukemia/lymphoma virus type 1 (HTLV-1) proviral DNA sequence was detected in the cellular DNA. On the other hand, the serum antibody titers to Epstein-Barr virus (EBV) were at high level. Phenotypic analysis of the leukemic cells was performed with surface markers by monoclonal antibodies. Peripheral blood lymphocytes were composed of OKT3+: 87.4%, OKT4+: 45.6%, OKT8+: 39.7%. BALF lymphocytes were composed of OKT3+: 99.0%, OKT4+: 38.0%, OKT8+: 69.5%. By means of two-color fluorescence flow cytometory, the peripheral blood lymphocytes separated the OKT4+/8- cell population from the OKT4-/8+ cell population. Almost no OKT4+/8+ cells were detected. Concerning the size of the cells, both the OKT4+ and the OKT8+ lymphocytes had nearly the same number of abnormal large lymphocytes, and morphologically, both populations had abnormally shaped lymphocytes.
These results suggest that the leukemic cells of the reported case were composed of two populations of T-lymphocytes that had helper/inducer markers or suppressor/cytotoxic markers.
