lewis-x-antigen and HTLV-I-Infections

Diagnosis of Hodgkin's disease (HD) is quite difficult in the patient with seropositivity for human T cell lymphotropic virus I (HTLV-I). Herein, two cases of Epstein-Barr virus (EBV)-associated HD, which occurred in males with seropositivity for anti-HTLV-I, are reported. One patient is alive and was diagnosed as having interfollicular HD with CD20+CD15-CD30-CD3-CD4-CD8-CD45RO-Read-Sternberg (R-S) cells. Positivity for EBV-encoded RNA 1 (EBER-1) and latent membrane protein 1 (LMP-1) was shown on follicular germinal center cells and R-S cells. In that case, neither T cell receptor (TCR) beta chain rearrangement nor integration of the HTLV-I provirus was demonstrated in the lymph nodes, although atyical lymphocytes (2%) were found in the peripheral blood. The other case pursued an aggressive clinical course and the patient was diagnosed as having an adult T cell leukemia/lymphoma (ATLL) because of the presence of anti-HTLV-I antibody, lymph node swelling, and the appearance of flower-like cells in the peripheral blood. However, an autopsy revealed no obvious ATLL cell infiltration in any of the organs examined. Multiple granulomatous lesions were found in the bone marrow, liver, kidneys, spleen, and lymph nodes. Reassessment of lymph node lesions in biopsies and granulomatous lesions in autopsy samples demonstrated that both lesions contained CD15+CD30+CD3-CD4-CD8-CD20-CD45RO-EBER-1+L MP-1+R-S cells, and they were considered to be a composite lymphoma of HD and ATLL. These two cases therefore suggest that EBV-associated HD can develop in patients with seropositivity for HTLV-I.

Topics: Antigens, CD; Fatal Outcome; Herpesviridae Infections; Herpesvirus 4, Human; Hodgkin Disease; HTLV-I Infections; Humans; Immunohistochemistry; In Situ Hybridization; Lewis X Antigen; Lymph Nodes; Male; Microscopy, Electron; Middle Aged; Polymerase Chain Reaction; Reed-Sternberg Cells; RNA, Viral; Tumor Virus Infections

A case of Hodgkin's disease (HD), lymphocyte depression (LD) type in an immunosuppressive patient is described. The patient was a 48-year-old male and his parents were born in the Kyushu area, which is an endemic area for adult T cell lymphoma/leukemia (ATL). He was seropositive for ATL virus (ATLV, also referred to as HTLV-I) and showed a marked immunosuppressive condition. He developed LD-HD and Pneumocystis carinii pneumonia, and died due to respiratory failure. The immunohistochemical and in situ hybridization analyses revealed that the Reed-Sternberg-like cells in the lymph node biopsy sample were positive for Ber-H2 (CD30), Leu-M1 (CD15), L-26 (CD20), Bcl-2, p53 and EBER, the viral genome of Epstein-Barr virus (EBV).

Topics: Antigens, CD20; Fatal Outcome; Herpesvirus 4, Human; Hodgkin Disease; HTLV-I Infections; Humans; Immunocompromised Host; Immunohistochemistry; In Situ Hybridization; Ki-1 Antigen; Leukocyte Common Antigens; Lewis X Antigen; Lymph Nodes; Male; Middle Aged; Opportunistic Infections; Pneumonia, Pneumocystis; Proto-Oncogene Proteins c-bcl-2; Reed-Sternberg Cells; RNA, Viral; Tumor Suppressor Protein p53

We describe a case of recurrent histiocytic necrotizing lymphadenitis (HNL) with aseptic meningitis. The patient was a 46-year-old male and a carrier of human T lymphotropic virus type I (HTLV-I). The patient had a past medical history of at least three relapses of HNL. In addition, his sister, who was also an HTLV-I carrier, had recurrent clinical episodes consistent with those of HNL, suggesting familial HNL occurrence. This observation suggests the possibility that HTLV-I infection is relevant to the pathogenesis of HNL.

Topics: Antibodies, Viral; Carrier State; CD8 Antigens; Cell Division; Fatal Outcome; Herpesviridae Infections; Herpesvirus 6, Human; Histiocytes; HTLV-I Infections; Human T-lymphotropic virus 1; Humans; Immunohistochemistry; Lewis X Antigen; Lymphadenitis; Male; Meningitis, Aseptic; Middle Aged; Necrosis; Pedigree; Recurrence