[A case of angiocentric immunoproliferative lesions in an ATL-virus carrier]

A 48-year-old woman was admitted to our hospital because of cough and low-grade fever. Chest X-ray films showed multiple ill-defined nodular shadows and laboratory findings showed that she was an ATL-virus carrier. Because the specimens obtained by transbronchial biopsy were not diagnostic, open thoracotomy was performed. Open lung specimens showed proliferation of lymphoid cells composed of polymorphorous lymphocytes, which do not represent cytologic atypia, plasma cells and histiocytes without necrosis. Several vessels were occluded by the infiltration of these cells. A diagnosis of angiocentric immunoproliferative lesions (Grade I), which was originally coined by Jaffe, was made. Complete remission was achieved by treatment with prednisolone and cyclophosphamide. This disease, which corresponds to lymphomatoid granulomatosis, is graded into three categories depending on the severity of cytologic and histologic malignancy. Although it has recently been suggested that its pathogenesis may be related to EB-virus infection, ATL-virus may have been a contributory factor in this case.