Primary Pulmonary T-cell Lymphoma in an HTLV-1 Carrier

Background. The incidence of primary pulmonary lymphomas is only 0.34%, and peripheral T-cell lymphoma is very rare. Moreover, there is no literature recording its appearance in a Human T lymphotropic virus type 1 (HTLV-1) carrier. Case. A 65-year old man with dry cough, fever, and chills was admitted with multiple pulmonary nodules and pleural effusion. High lymphocyte count and elevated adenosine deaminase (ADA) were found in the pleural effusion. Antitubercular therapy yielded no clinical or radiologic improvement. The patient was transferred to our hospital where lymphoma was confirmed from positive rearrangement of the TCR-β gene in cells in the pleural effusion. The patient was positive for HTLV-1 antibody, but did not have monoclonal integration of the pro-virus HTLV-1 in cells in the pleural effusion. Conclusion. This was the first case of an HTLV-1 carrier presenting with primary pulmonary T cell lymphoma.