Adult T-cell leukaemia/lymphoma with different histological features in a single lymph node

Area of Science:

• Oncology
• Hematology
• Pathology

Background:

• Adult T-cell leukaemia/lymphoma (ATLL) is a malignant neoplasm of mature T-lymphocytes.
• ATLL is associated with human T-lymphotropic virus type 1 (HTLV-1) infection.
• Typical ATLL presentations involve distinct histological subtypes.

Purpose of the Study:

• To report an unprecedented case of ATLL exhibiting multiple histological subtypes within a single lymph node.
• To discuss the diagnostic and pathological implications of this rare presentation.

Main Methods:

• Case report of a 76-year-old Japanese male patient.
• Clinical examination, peripheral blood analysis, imaging studies (ultrasound, CT).
• Cervical lymph node biopsy with histopathological examination and serological testing for HTLV-1.

Main Results:

• The lymph node biopsy revealed a complete effacement of normal architecture.
• Observed areas consistent with the pleomorphic cell variant of ATLL, classic Hodgkin lymphoma, and angioimmunoblastic T-cell lymphoma.
• Serological testing confirmed HTLV-1 positivity, leading to an ATLL diagnosis.

Conclusions:

• This is the first reported case of ATLL demonstrating diverse histological patterns within a single lymph node.
• The findings underscore the potential for histological heterogeneity in ATLL.
• This case expands the understanding of ATLL's pathological spectrum.