Yonago Acta medica 1997;40:125–131
Interstitial Pneumonia Developed in HTLV-I Carriers: Report of Two Cases
Naoto Burioka, Hisashi Suyama, Yuji Sugimoto, Hiroki Chikumi, Hiroki Yajima,
Katsuyuki Tomita, Eiji Hoshino, Yukio Matsumoto, Takao Sasaki and Makoto
Motoi*
Third Department of Internal Medicine and *Second Department of Pathology, Faculty of
Medicine, Tottori University, Yonago 683, Japan
Two carriers of human T-cell lymphotropic virus type I (HTLV-I) with interstitial
pneumonia are described. The first case, a 60-year-old man, was admitted with cough
and dyspnea on exertion. Light microscopy of a lung specimen obtained by a
transbronchial lung biopsy (TBLB ) showed thickening of the alveolar walls with infiltration
of lymphocytes and fibrosis of the pulmonary parenchyma. Immunohistochemical
analysis of the TBLB specimen showed positive staining in the lymphocytes for UCHL-1.
This case was suspected as HTLV-I associated bronchiolo-alveolar disorder. The second
case, a 74-year-old man, visited our hospital because of a persistent productive cough
and dyspnea on exertion. Light microscopy of the TBLB showed a slight thickening of
the alveolar walls and fibrosis of the pulmonary parenchyma with minimal infiltration
of lymphocytes. Only 2.2% of the bronchoalveolar lavage fluid consisted of lymphocytes.
The findings of the second case suggest that some factors other than T-lymphocytes
may be related with the development of interstitial pneumonia in HTLV-I carriers.
Interstitial pneumonia in HTLV-I carriers may be caused by as yet undiscovered
mechanisms. A cohort study involving residents of an area where HTLV-I is endemic should
be conducted to clarify the mechanism of pulmonary involvement in HTLV-I carriers.
Key words: human T-cell lymphotropic virus type I; HTLV-I associated bronchiolo-alveolar disorder; HTLV-I associated bronchopneumopathy; interstitial pneumonia; pulmonary fibrosis
