Abstract
Adult T-cell leukemia/lymphoma (ATLL) is a human malignancy associated with human T-cell leukemia virus type I (HTLV-I). ATLL frequently involves the skin.
To correlate the clinicopatholigical features and prognosis of ATLL patients with cutaneous lesions, we examined HTLV-I proviral state and the clinicopathological features of the cutaneous lesions of 80 cases with serum anti-ATL antibody, to clarify the correlation between macroscopic/histopathological findings and prognosis. Southern blot analysis was performed in all cases to detect monoclonal HTLV-I proviral DNA integration. The cutaneous lesions of 46 patients were positive for proviral DNA integration. The median survival time (MST) of the patients with monoclonal proviral DNA integration in cutaneous lesions was 14 months, which was markedly shorter than that of patients negative for proviral DNA integration (n=72 months). In the 46 cases with proviral DNA, 21 had solitary or multiple red nodules (including 3 with subcutaneous induration), 8 had multiple red papules, and 17 had erythema. Patients with papules and tumors had poorer prognoses than those with erythema. Histopathologically, the prognosis was poorer in patients with nodular or diffuse infiltration of medium to large sized lymphoma cells, compared to those with perivascular infiltration of small to medium sized lymphoma cells.
Our results showed a close correlation between clinicopathological features of HTLV-1 associated cutaneous lesions and prognosis. [Skin Cancer (Japan) 2006; 21: 268-272]
