A Case of Intussusception due to Tumor of the Adult T-cell Leukemia

Eiji Meguro¹⁾, Katsu Suzuki²⁾, Mitsuru Kikuchi²⁾, Mari Kamei²⁾, Kazuhiko Oikawa²⁾, Yukio Tomita²⁾, Toshifumi Kasai³⁾, Kazuyoshi Saito¹⁾

¹⁾Department of Surgery I, Iwata Medical University, School of Medicine
²⁾Department of Surgery, Miyako Prefectual Hospital
³⁾Department of Pathology II, Iwate Medical University, School of Medicine

Adult T-cell leukemia (ATL) usually presents systemic lymph node involvement, and extranodal presentation is rare. We experienced a patient in whom small bowel involvement necessitated surgical intervention. Sudden epigastraliga occurred in a 48-year-old man, who then visited Miyako Prefectural Hospital. Typical findings in the abdominal roentgenogram on admission suggested small bowel obstruction. Abdominal computed tomography showed a large tumor in the dilated intestine. Hematology on admission showed adult T-cell leukemia. Continuous nasal suction tube in insertion was done to decompress the small bowel dilation and alleviate symptoms. However, on the 20th day the patient's condition took a sudden turn for the worse, and laparotomy was done 22 days after admission. Small bowel intussusception was found about 160 cm and 320 cm from the ligament of Treitz, and the involved intestine was resected. A large tumor was found at the apex of the intussuscepted bowel. The mode of heredity and T-cell antigen-antibody reaction of the tumor were precisely in accordance with those of increased lymphocytes in peripheral blood.

Key words
adult T-cell leukemia, tumor-forming leukemia, intussusception

Reprint requests
Eiji Meguro Department of Surgery I, Iwate Medical University, School of Medicine
19-1 Uchimaru, Morioka, 020 JAPAN

Accepted
October 13, 1993

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