Conflict of interest: none.
Lung miliary micro-nodules in human T-cell leukemia virus type I carriers
Article first published online: 22 FEB 2013
© 2013 The Authors. Pathology International © 2013 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd
Volume 63, Issue 2, pages 108–112, February 2013
How to Cite
Fukuoka, J., Tominaga, M., Ichikado, K., Tanaka, T., Ichiyasu, H., Kohrogi, H., Ishizawa, S. and Suga, M. (2013), Lung miliary micro-nodules in human T-cell leukemia virus type I carriers. Pathology International, 63: 108–112. doi: 10.1111/pin.12030
- Issue published online: 7 MAR 2013
- Article first published online: 22 FEB 2013
- Manuscript Accepted: 21 DEC 2012
- Manuscript Received: 16 APR 2012
- Ministry of Health, Labor and Welfare
- case reports;
- human T-cell leukemia virus type-1;
- lymphoproliferative disorders
Human T-cell leukemia virus type 1 (HTLV-1) carriers are rarely subject to inflammatory disorders in multiple organs, other than the well-known complication, adult T-cell leukemia/lymphoma (ATLL). HTLV-1 associated bronchiolo-alveolar disorder (HABA) has been proposed as an immune mediated pulmonary reaction seen rarely in HTLV-1 carriers. The reported clinico-pathological patterns of HABA are diffuse panbronchiolitis (DPB) and lymphoid interstitial pneumonia (LIP).
We here report three cases of HTLV-1 carriers showing miliary micro-nodules throughout both lungs. Microscopic examination in the video assisted thoracic surgery biopsies demonstrated that all cases had multiple discrete micro-nodules which consisted of marked lymphoid infiltration, granulomas, eosinophils and a few foci of necrosis inside the granuloma. No findings indicating ATLL, other neoplastic conditions, infection or interstitial pneumonia, including DPB and LIP, were present following panels of special staining and immunohistochemical examinations. Two patients improved without treatment within one month, with no evidence of recurrence after 7 years. One patient showed slow deterioration of lung reticular shadows in spite of a low dose corticosteroid therapy (prednisolone 10 mg/day). We believe these cases may be a newly recognized variant of HABA.