Adult T-cell Leukemia with Severe Gastrointestinal Invasion, Especially Bizarre Lesions in the Colon, Report of a Case Toshiaki Ochiai 1 , Kenji Sakai 1 1Department of Internal Medicine, Fukuoka Prefectural Kaho Hospital Keyword: 成人T細胞性白血病 , 大腸病変 , 顆粒状隆起 pp.107-114
Published Date 1997/1/25
DOI https://doi.org/10.11477/mf.1403104961
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 A 59-year-old man was admitted to our hospital complaining of diarrhea and melena. Laboratory examinations on admission showed that white blood cell count had increased with abnormal lymphocytes with cleaved nuclei like flower cells, serum LDH was elevated, and serum anti HTLV-I antibody was positive. Therefore, we diagnosed his illness as adult T-cell leukemia (ATL). Radiologic and endoscopic examinations of the gastrointestinal tract revealed multiple erosions and small ulcers in the stomach and the small intestine. Severe reddish granular elevated lesions in the entire colon were observed. In addition, erosions and small ulcers in the sigmoid colon and flat elevated lesions in the rectum were observed. Histological examinations of the specimens from these lesions showed diffuse infiltration of abnormal lymphocytes similar to those in the peripheral blood. Thus, the patient was diagnosed as ATL with severe gastrointestinal involvement. We report this interesting case, because the gastrointestinal appearance, especially in the colon, was various and bizarre, and has never been reported.

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