Clinicopathologic,immunophenotypic and ultrastructrual analyses of ATLL patients with cutaneous involvement  

作　　者：汪晨 姚志远 廖军鲜 罗羽 马一盖 陈国敏 朱文元 

出　　处：《Chinese Medical Journal》1999年第5期77-81,共5页中华医学杂志（英文版）

摘　　要：Objective To study 4 cases of adult T cell leukemia/lymphoma (ATLL) as sociated with cutaneous lesions for clinicopathology, immunophenotype, human T cell leukemia/lymphoma virus type Ⅰ (HTLV Ⅰ) provirus DNA and their ultrastru cture. At the same time, HTLV Ⅰ provirus DNA of ATLL patients were also compar ed with 18 cases of cutaneous lymphoma (CL), two cases of actinic reticuloid as well as two cases of lymphocytic infiltration.Methods Immunohistochemistry studies were carried out on the infiltrati ng cells using monoclonal antibodies against CD45 RO, CD20, CD68 on paraffin e mbedded sections by ABC method and using monoclonal antibodies against CD3, CD4 and CD8 with indirect immunofluorescence (IIF) on frozen sections. Skin biopsies were examined by electron microscope. Serum and bone marrow cells were tested f or antibodies against HTLV Ⅰ associated antigen by IIF, and HTLV Ⅰ provirus DNA was examined by PCR method.Results The research showed four patients with ATLL manifesting cutaneo u s lesions, were subsequently found with additional systemic symptoms, as extensi vely enlarged superficial lymph node, abnormal increased IL 2 receptor, flower like cells in their peripheral blood and marrow. The HTLV Ⅰ provirus DNA was positi ve in the peripheral blood, bone marrow, cutaneous lesions and lymph node biopsy specimens by using PCR amplification of specific HTLV Ⅰ fragment while 18 cas es of the CL were negative for HTLV Ⅰ. The special ultrastructure of skin lesi ons was also found in ATLL patients.Conclusions The cutaneous involvement in ATLL is a type of cutaneous T cell lymphoma (CTCL) but shows some differential immunological markers for diffe rential diagnosis. The examination of HTLV Ⅰ antibodies or HTLV Ⅰ provirus D NA is necessary for diagnosis of ATLL. The ultrastrustural characteristics in skin lesions of ATLL were of atypic al lymphocytes and mononuclear cells invading the epidermis, and the mononuclear cells are possessing the phagocytic function and Objective To study 4 cases of adult T cell leukemia/lymphoma (ATLL) as sociated with cutaneous lesions for clinicopathology, immunophenotype, human T cell leukemia/lymphoma virus type Ⅰ (HTLV Ⅰ) provirus DNA and their ultrastru cture. At the same time, HTLV Ⅰ provirus DNA of ATLL patients were also compar ed with 18 cases of cutaneous lymphoma (CL), two cases of actinic reticuloid as well as two cases of lymphocytic infiltration.Methods Immunohistochemistry studies were carried out on the infiltrati ng cells using monoclonal antibodies against CD45 RO, CD20, CD68 on paraffin e mbedded sections by ABC method and using monoclonal antibodies against CD3, CD4 and CD8 with indirect immunofluorescence (IIF) on frozen sections. Skin biopsies were examined by electron microscope. Serum and bone marrow cells were tested f or antibodies against HTLV Ⅰ associated antigen by IIF, and HTLV Ⅰ provirus DNA was examined by PCR method.Results The research showed four patients with ATLL manifesting cutaneo u s lesions, were subsequently found with additional systemic symptoms, as extensi vely enlarged superficial lymph node, abnormal increased IL 2 receptor, flower like cells in their peripheral blood and marrow. The HTLV Ⅰ provirus DNA was positi ve in the peripheral blood, bone marrow, cutaneous lesions and lymph node biopsy specimens by using PCR amplification of specific HTLV Ⅰ fragment while 18 cas es of the CL were negative for HTLV Ⅰ. The special ultrastructure of skin lesi ons was also found in ATLL patients.Conclusions The cutaneous involvement in ATLL is a type of cutaneous T cell lymphoma (CTCL) but shows some differential immunological markers for diffe rential diagnosis. The examination of HTLV Ⅰ antibodies or HTLV Ⅰ provirus D NA is necessary for diagnosis of ATLL. The ultrastrustural characteristics in skin lesions of ATLL were of atypic al lymphocytes and mononuclear cells invading the epidermis, and the mononuclear cells are possessing the phagocytic function and

关 键 词：adult T  cell leukemia/lymphoma (ATLL) cutaneous T   cell lymphoma HTLV  Ⅰ provirus DNA polymerase chain reactio n 

分 类 号：R733.702[医药卫生—肿瘤]