造血幹細胞移植後尿中にアデノウイルス１１型感染細胞を認めた成人Ｔ細胞性白血病（ＡＴＬ）の２例

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  • Adenovirus type 11 infected cells of two patients of ATL (Adult T cell leukemia) treated by stem cell transplant

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Background: We reported two immunocompromised patients treated for leukemia who developed hemorrhagic cystitis caused by ADV type 11 infection.<BR>Cases: The first patient was a 38-year-old man with ATL after bone marrow transplant. The second was a 58-year-old woman with ATL treated by stem cell transplant.<BR>Adenovirus (ADV) type 11 was detected by PCR from urine in both cases.<BR>Histologically (case 1), the kidney showed tubuli with smudge basophilic inclusion in mildly enlarged nuclei, prominent necrosis, and atypical lymphocytes infiltration.<BR>An electron microscopic examination of renal tissue in case 1 showed hexagonal viral particles 70 to 80 nm in diameter both in the nucleus and cytoplasm.<BR>Cytologically, bleeding and necrosis were observed in the background in both cases. Each infected cell contained a large basophilic homogeneous intranuclear inclusion body: smudge cells. Smudge cells featured single cells and cell clusters. A small number of infected cells had an “owl eye” appearance: Cowdry type A.<BR>Conclusion: A careful observation with knowledge of characteristic features of ADV type 11 infected cells leads to an appropriate diagnosis.

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