白血病細胞の眼内浸潤で初発した成人T細胞白血病の1例

Adult T-cell leukemia with intraocular infiltration

　白血病細胞の眼内浸潤で初発した成人T細胞白血病（ATL）の1例を報告した。

　症例は宮崎県在住の38歳男性である。右眼網膜の広範な滲出性病変および眼内炎様症状による視力低下で初発し，後に左眼にも限局性滲出性病変が生じた。経過中に精神症状を示し，3か月の経過で死亡した。死亡する5日前に初めて末梢血にATL細胞の出現を確認した。剖検で，眼球，中枢神経，リンパ節，その他諸臓器に特異なATL細胞の浸潤を認めた。本症例の眼症状と精神症状はATLの細胞浸潤によるものと診断した。

A 38-year-old male presented with decreased vision in his right eye since 2 weeks before. We detected severe intraocular inflammation with widespread flat retinal detachment and retinal vasculitis in the affected eye. Two weeks later, a focal exudative lesion with retinal vasculitis devel-oped nasal to the disc in the left eye. He then manifested mental deterioration and died 3 months after onset of ocular symptoms. Prior to death, the condition was diagnosed as adult T-cell leukemia (ATL) based on presence of ATL cells in the peripheral blood and HTLV-1 provirus in the DNA of the cells. Autopsy showed ATL cell infiltration in the eye, brain and other systemic organs. ATL cells infiltrated diffusely in the retina and the disc, and accumulated densely along the retinal veins. The patient was resident in Miyazaki in southern Kyushu island, where ATL is known to occur in a rather high frequency.