Multiple polypoid lesions with erosion of the gastric mucosa in adult T-cell lymphoma/leukemia superimposed on cytomegalovirus infection

eJHaem

article

Fumihiko Kouno¹  Keisuke Shindo²  Shinsaku Imashuku²  Takashi Miyoshi²  Yutaka Shimazu² 

[1] Department of Pathology, Uji Tokushukai Medical Center;Department of Hematology, Uji Tokushukai Medical Center

关键词: cytomegalovirus;    HTLV-1;    malignant lymphoma;   

DOI  :  10.1002/jha2.476

来源: Wiley

【 摘 要 】

We report here unique endoscopic findings of cytomegalovirus(CMV) gastritis associated with adult T-cell leukemia/lymphoma(ATLL). A 67-year-old Japanese man presented to a hematologistwith a month history of appetite loss. Physical examination showedblurred consciousness (GCS E4V2M5) with labored breathing andhypotension. Blood examination revealed hypercalcemia (adjustedCa: 3.24 mmol/L), anemia (Hb: 70 g/L), and leukocytosis (whiteblood cell count: 21.3 × 109/L) with abnormal lymphocytes (7%).Human T-cell lymphotropic virus type 1 antibody and provirus DNAmonoclonality were positive. A blood transfusion was given, andnoradrenaline and denosumab were administered. Upper gastrointestinal tract endoscopy showed multiple polypoid lesions withredness and erosive surface (upper left; see Figure 1). A gastricbiopsy specimen showed the presence of CD3+CD4+CD8− T cells,compatible with the gastric involvement by ATLL, and CMV gastritispresenting with inclusion bodies positive for anti-CMV antibody byimmunohistochemistry (upper right and lower left; see Figure 1).

【 授权许可】

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