A Case of Adult T-Cell Leukemia Lymphoma in the Nose and Larynx

Adult T-cell leukemia lymphoma (ATLL) is a T cell tumor that was first described in Japan by Takatsuki in 1975. ATLL is induced by human T-lymphotropic virus type 1 (HTLV-1) infection and is associated with a poor prognosis. Carriers who have been vertically infected with the virus through breastmilk may develop ATLL during adulthood, with a reported lifetime incidence of about 5%. The pathological abnormalities associated with ATLL include skin rash, splenohepatomegaly, lymph node swelling, and so on. Such cases are often diagnosed in the Departments of Internal Medicine and Dermatology. Although such lesions are rarely found in the ear, nose and throat region, we experienced a case of ATLL with lesions in the larynx and nasal cavity. A 45-year-old woman complained of odynophagia and hoarseness. On physical examination, granulomas and crust formations were observed in the anterior commissure and the nose. To obtain a definite diagnosis, we biopsied the lesions during laryngeal surgery. The pathological findings suggested an ATLL. The provirus was identified in a blood sample, and the diagnosis was confirmed. Because ATLL is associated with a poor prognosis, an early diagnosis is desirable.