Adult T-cell leukemia/lymphoma with a giant gastric tumor: a case report

A rare case of adult T-cell leukemia/lymphoma with a giant exophytic gastric tumor invading the anterior abdominal wall is presented. The patient was a 52-year-old woman, who had a history of strongyloidiasis. Although the patient was serologically positive for HTLV-I antibody, there were no lymphoma cells in the peripheral blood or systemic lymphadenopathy. After two cycles of combination chemotherapy, the tumor was surgically resected. The pathological diagnosis of the resected specimen was T-cell lymphoma of the diffuse mixed cell type. Flow-cytometric analysis of the lymphoma showed a CD4+ and CD8+ phenotype. One month after surgery, the patient developed hypercalcemia, resulting in acute renal and respiratory failure, and died. The prognosis of lymphoma-type ATL is known to be extremely poor, and thus we should bear in mind that ATL can take the form of a primary gastric mass without leukemic manifestations.