Morning report unknown

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Morning report unknown 92
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• 65 y/o male born in Jamaica who immigrated to the
  US 2 years ago presented with diffuse
  lymphadenopathy and marked hepatosplenomegaly.
  You also note a skin rash

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Labs

• WBC 17K, Hct 42, Plt 350
• Cr 1.0
• Ca 13
• Elevated LDH/ Alk Phos

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Flower Cells w/ hyperlobulated nuclei
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• What is the diagnosis?
• What are the disease associations associated with
  this process?

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HTLV1

• Most patients are asymptomatic (96)
• T cell leukemia/lymphoma
• Onset delayed by 20-30 years
• Lymphadenopathy/HSM/abn leukocytes
• Hypercalcemia
• Lytic bone lesions
• In a person from Japan/Carribbean
• 4 types

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HTLV1

• Tropical spastic paraparesis or HTLV-1 associated
  myelopathy
• Weakness of the lower extremities, spastic, rigid
• Insidious and progressive
• Dx screen with ELISA followed by Western Blot