Cerebral mass lesions associated with adult T-cell leukemia/lymphoma

Three patients with adult T-cell leukemia/lymphoma (ATLL) accompanied by cerebral mass lesions in their courses are reported. The findings of cerebrospinal fluid and their history suggested that those three cerebral involvements were the mass lesions derived from ATLL. Two of the three patients had acute type and the other one had chronic type ATLL. During the same period in which these three patients were observed, we experienced 17 other patients with ATLL. Although this group included 12 lymphoma type and five acute type ATLL, involvement of the central nervous system (CNS) was not observed in these 17 patients. The incidence of CNS involvement was 3/20 (15%). The prognoses of the three patients after the occurrence of CNS involvement was 1, 4, and 8 months, respectively. In these three patients, cerebral lesions became the cause of death for two patients although they continued to be in complete remission hematologically. Cerebral lesions, once occurring, are very hard to cure and spoil the quality of life for sufferers. From these points, prophylactic therapy against central nervous system involvement seems necessary not only for acute leukemias, but also for ATLL patients.