A 42-year-old man from southern Japan presents with generalized lymphadenopathy, skin lesions, hypercalcemia, and a WBC of 120,000/uL. The circulating neoplastic cells are large lymphoid forms with deeply convoluted multilobed nuclei. Serology for a retrovirus is positive. Which virus is responsible?
- A Epstein-Barr virus
- B Human T-cell leukemia virus type 1 (HTLV-1) ✓
- C Human herpesvirus 8
- D Human immunodeficiency virus
Correct answer: B. Human T-cell leukemia virus type 1 (HTLV-1)
Explanation
Adult T-cell leukemia/lymphoma is caused by HTLV-1 and clusters in southwest Japan, the Caribbean basin, West Africa, and parts of South America. The convoluted cloverleaf or flower cells, hypercalcemia from osteoclast activation, skin involvement, and aggressive course are characteristic. HHV-8 causes primary effusion lymphoma and multicentric Castleman disease, while EBV is linked to Burkitt lymphoma and classical Hodgkin lymphoma rather than this T-cell entity.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.