ADULT T-CELL LEUKEMIA/LYMPHOMA WITH MULTIPLE INTEGRATION OF HTLV-1 PROVIRUS PRESENTING AS AN

(ATLL) is a highly aggressive T-cell lymphoma and etiologically associated with human T-lymphotropic virus type 1 (HTLV-1). Patients with ATLL commonly present with leukemic changes, systemic lymphadenopathy, and/or extranodal lesion and have very poor prognosis. Methods and Results. We describe a rare case of ATLL pre-senting as an isolated paranasal mass. Southern blot analysis of the biopsied specimens demonstrated multiple integration bands of HTLV-1 provirus of different intensities. Chemotherapy resulted in complete resolution of the paranasal mass. There-after, the patient showed an indolent clinical course with leuke-mic changes and pulmonary and cutaneous ATLL lesions and remains alive more than 5 years from diagnosis. Conclusion. ATLL should be included in the differential diag-nosis of sinonasal lymphoma, although the event is rare. Multiple HTLV-1 provirus integrations of different intensities may be indic-ative of good prognosis for ATLL. VC 2007 Wiley Periodicals