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The Joseph Goldberger Clinical Investigator Lecture

Thomas A. Waldmann, MD

JAMA. 1995;273(9):735-737.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

SELECTED CASE

A 37-year-old Jamaican woman developed a generalized erythematous maculopapular rash. She had a peripheral white blood cell (WBC) count of 37x10⁹/L, 75% of which were malignant T cells with convoluted nuclei. The diagnosis of human T-cell lymphotropic virus type I (HTLV-I)—related adult T-cell leukemia/lymphoma (ATL) was supported by high titers of antibodies to HTLV-I in the peripheral blood. The patient was referred to the National Institutes of Health for treatment.

Results of physical examination on admission were normal, with the exception of a generalized nonpuritic maculopapular skin rash. The patient manifested overt leukemia with a peripheral WBC count of 32.6 x10⁹/L, 83% of which were malignant T cells. The phenotype of the malignant cells was CD3⁺, CD4⁺, CD8^-, CD7^-, and CD25⁺. The serum concentration of soluble CD25 was elevated to 3645 units (normal geometric mean 235, with 95% confidence interval of 112 to 502 . . . [Full Text PDF of this Article]

Author Affiliations
From the Metabolism Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md.

Footnotes
Reprint requests to the Metabolism Branch, National Cancer Institute, Bldg 10, Room 4N115, National Institutes of Health, Bethesda, MD 20892 (Dr Waldmann).

Grand Rounds at the Clinical Center of the National Institutes of Health section editors: John I. Gallin, MD, the Clinical Center of the National Institutes of Health, Bethesda, Md; David S. Cooper, MD, Contributing Editor, JAMA.

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