A 55-year-old man from southwestern Japan presents with skin nodules, lytic bone lesions, corrected serum calcium of 14 mg/dL, and lymphadenopathy. Peripheral smear shows pleomorphic lymphoid cells with multilobated, cloverleaf nuclei. Flow cytometry shows CD4-positive, CD25-positive T cells. Which virus is etiologically linked to this neoplasm?
- A Human herpesvirus 8
- B Human T-cell leukemia virus type 1 ✓
- C Epstein-Barr virus
- D Hepatitis C virus
Correct answer: B. Human T-cell leukemia virus type 1
Explanation
Adult T-cell leukemia/lymphoma is caused by HTLV-1, endemic in southwestern Japan, the Caribbean basin, and parts of West Africa. Hypercalcemia from osteoclast activation, lytic bone lesions, skin lesions, and flower-shaped CD4-positive, CD25-positive T cells are characteristic. HHV-8 is linked to primary effusion lymphoma and Kaposi sarcoma, while EBV drives endemic Burkitt lymphoma and many classical Hodgkin lymphoma cases.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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