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Adult T-cell leukemia/lymphoma accompanying follicular mucinosis: a case report with review of the literature.

Abstract
Follicular mucinosis is recognized as one of the histopathological reaction patterns characterized by the accumulation of mucin within follicular epithelium. It is induced by various causes including inflammatory diseases, and more than half of the cases are associated with malignant lymphoma, mainly mycosis fungoides. Herein, we describe the third documented case of adult T-cell leukemia/lymphoma (ATLL) accompanying follicular mucinosis. A 72-year-old Japanese male presented with persistent erythema in his arm and neck. Laboratory tests demonstrated positivity for human T-cell leukemia virus (HTLV)-1 antibodies. Histopathological study of the biopsy specimen from the neck revealed superficial perivascular, nodular, and intrafollicular lymphocytic infiltrations. These lymphocytes were small- to medium-sized and had convoluted nuclei. Mucoid material deposition was observed within the hair follicles, and it was digested by hyaluronidase. Immunohistochemically, these lymphocytes were positive for CD3, CD4, CD25, and Foxp3. Accordingly, an ultimate diagnosis of ATLL accompanying follicular mucinosis was made. The skin is the most common extralymphatic site of involvement of ATLL. The present case clearly demonstrated that albeit extremely rare, ATLL can cause follicular mucinosis. Therefore, ATLL should be included in the differential diagnostic consideration of follicular mucinosis.
AuthorsMitsuaki Ishida, Muneo Iwai, Keiko Yoshida, Akiko Kagotani, Hidetoshi Okabe
JournalInternational journal of clinical and experimental pathology (Int J Clin Exp Pathol) Vol. 6 Issue 12 Pg. 3014-8 ( 2013) ISSN: 1936-2625 [Electronic] United States
PMID24294393 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • Biomarkers, Tumor
  • HTLV-I Antibodies
Topics
  • Aged
  • Biomarkers, Tumor (analysis)
  • Biopsy
  • Diagnosis, Differential
  • HTLV-I Antibodies (blood)
  • Humans
  • Immunohistochemistry
  • Leukemia-Lymphoma, Adult T-Cell (complications, immunology, pathology, virology)
  • Male
  • Mucinosis, Follicular (diagnosis, etiology)
  • Predictive Value of Tests
  • Skin Neoplasms (complications, immunology, pathology, virology)

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