Involvement of the Large Intestines in Patients with Adult T-cell Leukemia Shin-ichiro Aozaki 1 , Yoshito Nishimata 2 , Hiroto Nishimata 2 1Division of Internal Medicine, Saiseikai Sendai Hospital 2Nanpu Hospital Keyword: ATL , 大腸病変 , 消化管浸潤様式 , 画像所見 , 鑑別診断 pp.917-926
Published Date 1995/6/25
DOI https://doi.org/10.11477/mf.1403105453
  • Abstract
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 We studied involvement of the large intestine in seven patients with adult T-cell leukemia (ATL) with regard to radiographic as well as endoscopic characteristics and infiltrative forms of the tumor cells.

 The large intestine was found to be extensively involved in all the patients. We classified the cases into three types according to the radiographic and endoscopic findings as well as to the infiltrative forms of tumor cells: 1) diffusely infiltrating type, 2) multiple and diffusely infiltrating type, 3) multiple nodular type. In the diffusely infiltrating types, tumor cells diffusely infiltrate to the intestinal wall without mass formation. Radiographically and endoscopically, each of our two cases of this type showed a fine granular pattern or a granular pattern of the mucosa. A gyri-like appearance is also reported in this type. In the multiple and diffusely infiltrating type, tumor cells diffusely infiltrate with innumerable small elevated lesions. Our case of this type had an appearance resembling extensivelyspreading erosive gastritis. In the multiple nodular type, tumor cells infiltrated forming multiple polypoid lesions with central depression. Our four cases of this type had the appearance of so-called multiple lymphomatous poyposis (MLP).

 Our patients with diffusely infiltrating type tumor cells suffered from refractory diarrhea that was suspected to be caused by the infiltrated tumor cells, but such diarrhea was not seen in the patients of the other two types.

 ATL is one of the systemic multiple lymphomas that has a strong tendency to infiltrate to various organs and/or to be leukemic. It is suggested that such characteristics of ATL are closely related to the various forms and degree of infiltration of tumor cells, causing variform lesions in the large intestine.

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