Abstract
We report a patient from an endemic area of adult T-cell leukemia/lymphoma (ATLL), who developed lymphoma with features characteristic of Hodgkin's disease (HD). Large atypical Reed-Sternberg/Hodgkin's cells (RS/H cells) had a CD3-CD15+CD20-CD30+CD45RO- immunophenotype. Epstein-Barr virus (EBV) latent membrane protein and EBV-encoded small RNA were detected in the RS/H cells. The patient received C-MOPP/ABVD chemotherapy for the HD resulting in a partial response. However, relapse occurred and he died of disease progression associated with serious bacterial infection. Although serial lymph node biopsies revealed consistent presence of the EBV-positive RS/H cells, the background small lymphocytes showed progressive increase in pleomorphism and nuclear irregularity. The lymphocytes had the T-cell phenotype, CD3+CD4+CD7-CD8-. Southern blot analysis using DNA probes for the human T-cell lymphotrophic virus-I (HTLV-I) and the T-cell receptor beta-chain gene demonstrated expansion of the HTLV-I infected monoclonal T-cells with the disease progression. We concluded that the patient synchronously presented two independent lymphoproliferative disorders; EBV-associated HD and ATLL resulting from HTLV-I infection.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Antigens, CD / analysis
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Bleomycin / administration & dosage
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Cyclophosphamide / administration & dosage
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Dacarbazine / administration & dosage
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Doxorubicin / administration & dosage
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Fatal Outcome
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Herpesviridae Infections / complications*
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Herpesviridae Infections / virology
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Herpesvirus 4, Human / isolation & purification*
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Hodgkin Disease / complications*
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Hodgkin Disease / drug therapy
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Human T-lymphotropic virus 1 / isolation & purification*
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Humans
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Immunophenotyping
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Japan / epidemiology
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Leukemia-Lymphoma, Adult T-Cell / complications*
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Leukemia-Lymphoma, Adult T-Cell / epidemiology
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Lymph Nodes / pathology
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Male
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Middle Aged
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Neoplastic Stem Cells / chemistry
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Prednisone / administration & dosage
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Procarbazine / administration & dosage
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RNA, Viral / analysis
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Reed-Sternberg Cells / chemistry
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Reed-Sternberg Cells / virology
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Tumor Virus Infections / complications*
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Tumor Virus Infections / virology
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Vinblastine
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Vincristine / administration & dosage
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Viral Matrix Proteins / analysis
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Virus Activation / drug effects
Substances
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Antigens, CD
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EBV-associated membrane antigen, Epstein-Barr virus
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RNA, Viral
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Viral Matrix Proteins
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Bleomycin
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Procarbazine
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Vincristine
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Vinblastine
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Dacarbazine
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Doxorubicin
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Cyclophosphamide
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Prednisone
Supplementary concepts
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ABVD protocol
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COPP protocol