Stomach and Intestine(Tokyo) Volume 46, Issue 3 (March 2011)

HTLV-1 and Lower Gastrointestinal Tract Lesions Naoyuki Yamaguchi 1 , Hajime Isomoto 1 , Ken Ohnita 2 , Fuminao Takeshima 2 , Saburo Shikuwa 2 , Shigeru Kohno 1 , Kazuhiko Nakao 2 1Department of Endoscopy, Nagasaki University Hospital, Nagasaki, Japan 2Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan Keyword: 成人T細胞性白血病/リンパ腫 , HTLV-1 , 下部消化管病変 , 多発性・多彩性 pp.275-281
Published Date 2011/3/25
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 We reviewed intestinal lesions in patients with ATL/L(adult T-cell leukemia/lymphoma), which is caused by human T-cell leukemia virus type 1(HTLV-1). ATL/L cells have an aggressively invasive nature, and highly infiltrate the gastrointestinal tract. In our series of 40 cases, there were 7cases(17.5%)of small intestinal involvement by ATL/L. The most frequent macroscopic type was the mass-forming one, but the multiple polypoid type is most commonly reported in the literature. On the other hand, 10 out of 40 ATL/L patients(25%)had large intestinal involvement : the multiple polypoid type was most frequently observed in our series. In general, ATL/L cells diffusely infiltrate the intestine and multiply, possibly in association with abundant distribution of gut-associated lymphoid tissue throughout the intestine. Again, patients with HTLV-1 infection fall into the immune-deficient state before ATL/L appears, and thus, not uncommonly, give rise to opportunistic and sometimes lethal infection with such pathogens as cytomegalovirus and stercoral strongyloides. It is necessary pay attention to not only to intestinal involvement but also to gastrointestinal infection, which can consist of various manifestations in this devastating disease.

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46巻3号 (2011年3月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院