An Unusual Association of Adult T-Cell Leukemia/Lymphoma With Hyalohyphomycosis

Am J Dermatopathol. 2016 May;38(5):370-3. doi: 10.1097/DAD.0000000000000533.

Abstract

Infection by human T-cell lymphotropic virus (HTLV-1) causes deregulation of the immune system, which makes the infected individuals more susceptible to infectious diseases. Immune deregulation is even more pronounced in HTLV-1 carriers with adult T-cell leukemia/lymphoma (ATLL), which results in frequent opportunistic infections. Hyalohyphomycosis is a rare subcutaneous mycosis which is more commonly associated with immunocompromised patients. We report a case of a HTLV-1-infected man with skin tumors, inguinal lymphadenomegaly, and lymphocytosis. Histopathological examination of skin biopsies revealed a T-cell lymphoma intermingled with a granulomatous process with abscesses and hyaline-septated hyphae. The lymph node showed only a T-cell lymphoma. The patient was diagnosed with acute ATLL and hyalohyphomycosis. He was treated with itraconazole for the subcutaneous mycosis and with chemotherapy for ATLL. A few months later, despite the treatment, he died because of progression of ATLL.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Biopsy
  • Dermatomycoses / diagnosis
  • Dermatomycoses / drug therapy
  • Dermatomycoses / immunology*
  • Dermatomycoses / microbiology
  • Disease Progression
  • Fatal Outcome
  • HTLV-I Infections / diagnosis
  • HTLV-I Infections / immunology*
  • HTLV-I Infections / virology
  • Human T-lymphotropic virus 1 / immunology*
  • Human T-lymphotropic virus 1 / isolation & purification
  • Humans
  • Hyalohyphomycosis / diagnosis
  • Hyalohyphomycosis / drug therapy
  • Hyalohyphomycosis / immunology*
  • Hyalohyphomycosis / microbiology
  • Immunocompromised Host*
  • Leukemia-Lymphoma, Adult T-Cell / diagnosis
  • Leukemia-Lymphoma, Adult T-Cell / drug therapy
  • Leukemia-Lymphoma, Adult T-Cell / immunology*
  • Leukemia-Lymphoma, Adult T-Cell / virology
  • Male
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Antineoplastic Agents