A 55-year-old man from coastal Brazil presents with generalized lymphadenopathy, skin nodules, lytic bone lesions, serum calcium 13.2 mg/dL, and circulating lymphoid cells with deeply lobulated, cloverleaf-like nuclei. Which virus is the causative agent of this neoplasm?

• A Hepatitis C virus
• B Epstein-Barr virus
• C Human herpesvirus 8
• D 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 South America and Africa. It presents with skin lesions, lytic bone lesions, hypercalcemia from osteoclast activation, and characteristic flower cells in the blood. HHV-8 is linked to primary effusion lymphoma, EBV to endemic Burkitt lymphoma and some Hodgkin lymphoma, and hepatitis C to splenic marginal zone lymphoma.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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