TAILIEUCHUNG - Chapter 105. Malignancies of Lymphoid Cells (Part 21)

Rare patients with localized early stage mycosis fungoides can be cured with radiotherapy, often total-skin electron beam irradiation. More advanced disease has been treated with topical glucocorticoids, topical nitrogen mustard, phototherapy, psoralen with ultraviolet A (PUVA), electron beam radiation, interferon, antibodies, fusion toxins, and systemic cytotoxic therapy. Unfortunately, these treatments are palliative. Adult T Cell Lymphoma/Leukemia Adult T cell lymphoma/leukemia is one manifestation of infection by the HTLV-I retrovirus. Patients can be infected through transplacental transmission, mother's milk, blood transfusion, and by sexual transmission of the virus. Patients who acquire the virus from their mother through breast milk are most likely to. | Chapter 105. Malignancies of Lymphoid Cells Part 21 Rare patients with localized early stage mycosis fungoides can be cured with radiotherapy often total-skin electron beam irradiation. More advanced disease has been treated with topical glucocorticoids topical nitrogen mustard phototherapy psoralen with ultraviolet A PUVA electron beam radiation interferon antibodies fusion toxins and systemic cytotoxic therapy. Unfortunately these treatments are palliative. Adult T Cell Lymphoma Leukemia Adult T cell lymphoma leukemia is one manifestation of infection by the HTLV-I retrovirus. Patients can be infected through transplacental transmission mother s milk blood transfusion and by sexual transmission of the virus. Patients who acquire the virus from their mother through breast milk are most likely to develop lymphoma but the risk is still only and the latency averages 55 years. Nationwide testing for HTLV-I antibodies and the aggressive implementation of public health measures could theoretically lead to the disappearance of adult T cell lymphoma leukemia. Tropical spastic paraparesis another manifestation of HTLV-I infection Chap. 181 occurs after a shorter latency 1-3 years and is most common in individuals who acquire the virus during adulthood from transfusion or sex. The diagnosis of adult T cell lymphoma leukemia is made when an expert hematopathologist recognizes the typical morphologic picture a T cell immunophenotype . CD4 positive and the presence in serum of antibodies to HTLV-I. Examination of the peripheral blood will usually reveal characteristic pleomorphic abnormal CD4-positive cells with indented nuclei which have been called flower cells Fig. 105-10 . Figure 105-10 Saure F UP A r DL. Ẹ-r unw ld E. H ui r L. Lũng OL. j m ían jL. L fC lỉC j 5- jĩrr ArâeỹnỈKS i jfat F7 J Kt Ki0 i 17HS Edition Copyright tì HqQí -Hi l c mp ni f Inc A1 llghlí ri .. Adult T cell leukemia lymphoma. Peripheral blood smear showing leukemia .

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