Cutaneous T cell lymphomas: mycosis fungoides, Sezary syndrome and HTLV-I-associated adult T cell leukemia (ATL) in Mali, West Africa: a clinical, pathological and immunovirological study of 14 cases and a review of the African ATL cases
Autor: | N Fouchard, A Mahe, M Huerre, S Fraitag, F Valensi, E Macintyre, F Sanou, G de The, A Gessain |
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Rok vydání: | 1998 |
Předmět: |
Adult
Male Cancer Research Pathology medicine.medical_specialty viruses T-cell leukemia Mali Cutaneous lymphoma Mycosis Fungoides immune system diseases hemic and lymphatic diseases medicine Humans Leukemia-Lymphoma Adult T-Cell Sezary Syndrome Aged Aged 80 and over Human T-lymphotropic virus 1 Mycosis fungoides biology Gene Rearrangement gamma-Chain T-Cell Antigen Receptor business.industry Human T-lymphotropic virus 2 Hematology Gene rearrangement Middle Aged medicine.disease biology.organism_classification Peripheral T-cell lymphoma Lymphoma T-Cell Cutaneous Lymphoma Oncology Female business CD8 |
Zdroj: | Leukemia. 12:578-585 |
ISSN: | 1476-5551 0887-6924 |
Popis: | Cutaneous T cell lymphomas (CTCL) are rare lymphoproliferative diseases, which are frequently suspected to be of viral origin. As very few data were available concerning cutaneous T cell lymphomas in tropical Africa, we undertook a clinical, histopathological, immunological and viro-molecular study of patients with a clinical diagnosis of cutaneous lymphoma, in Bamako, Mali. While prior to this study, no case of CTCL had been reported in this country, 14 patients (five women, nine men; mean age 58 years) with a diagnosis of cutaneous lymphoma were seen over a period of 30 months (1992-1994) in the only dermatological department in Mali. Clinically, the most frequent pattern was an infiltrated erythrodermia similar to Sezary syndrome. Nodular lesions and/or plaques were rarely observed. All these cutaneous tumors were T cell lymphoproliferations, only one expressing the CD8+ antigen. A comprehensive analysis of all the available data permitted characterization of three cases of adult T cell leukemia/lymphoma (ATL) associated with HTLV-I (one definitive case, of leukemic type, with demonstration of clonal integration of HTLV-I proviral genome and two probable ATL cases), three cases of Sezary syndrome (SS), two cases of mycosis fungoides (MF) and five cases of pleomorphic cutaneous lymphoma. In one case, the differentiation between MF and pleomorphic cutaneous lymphoma could not be established. HTLV-I serological and/or molecular markers were restricted to the three ATL cases. From the unique definitive ATL case, a T cell line was established from culture of peripheral blood mononuclear cells and sequence analysis of the env gene and the U3-LTR region demonstrated that the virus present in this patient belonged to the cosmopolitan subtype A. Thus, we report here the first evidence of HTLV-I infection and associated ATL in Mali. This is the second ATL case described for the whole Sahelian region (one ATL of the lymphoma type was reported previously in a Mauritanian patient). Furthermore, we demonstrate that the main types of CTCL described in Europe and North America are also present in this African area and that the prevalence of these diseases is greatly underestimated in such regions. Furthermore, no association was observed between HTLV-I/II infection and SS, MF or pleomorphic cutaneous lymphoma in Mali in contrast to other studies. |
Databáze: | OpenAIRE |
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