HTLV-I-associated lymphoma involving the entire alimentary tract and presenting with an acquired immune deficiency

A patient with HTLV-I-associated adult T cell lymphoma presented like a patient with the acquired immune deficiency syndrome (AIDS) with peripheral lymphadenopathy, profuse diarrhea, weight loss, night sweats, and multiple opportunistic infections. Infections included cytomegalovirus, Pneumocystis, Histoplasma, Strongyloides, Giardia, and Staphylococcus aureus. Histoplasma has not previously been associated with this lymphoma. The lymphoma involved the entire alimentary tract from pharynx to rectum, which has not previously been reported for adult T cell lymphoma, and is rare for any lymphoma, with only one case reported in this century. Despite extensive gastrointestinal involvement, steatorrhea was not present, perhaps due to preservation of normal intestinal villous architecture.