[Adult T-cell leukemia (chronic type) with unusual surface phenotype CD 4+5+8-, Leu 7+ at acute crisis]

Chronic adult T-cell leukemia with surface phenotype CD 4+5+8-, Leu 7+ at acute crisis was presented. A 43-year-old female visited our hospital complaining of generalized lymphadenopathy and skin rash in December, 1973. Peripheral blood picture and histological findings of skin led to the diagnosis of malignant lymphoma (leukemic type). Intermittent chemotherapy kept white blood cell count less than 25,000/microliters for more than 9 years. In January, 1983, abnormal lymphocytes began to increase and reached 100,000/microliters or over in a few months. Surface marker study showed their phenotype as CD 4+5+8-, Leu 7+ and anti-ATLA antibody was positive in the patient, her son and her daughter. Intensive chemotherapy was ineffective and she died in August, 1983. Histological diagnosis of lymph-nodes on autopsy was malignant lymphoma (diffuse, small cell type). This case is considered unusual in both clinical course and surface phenotype of its leukemic cells.