小池 城司, 森岡　 英次, 石橋 大海, 大塚 輝久, 仁保 喜之

George KOIKE, Eiji MORIOKA, Hiromi ISHIBASHI, Teruhisa OTSUKA, Yoshiyuki NIHO

九州大学医学部第一内科

First Department of Internal Medicine, Faculty of Medicine, Kyushu University

キーワード : Adult T-cell leukemia (ATL) , Hepatic invasion, Target sign

A 54-year-old Japanese female was admitted to our hospital because of slight fever and generalized lymphadenopathy. The clinical and hematological examinations confirmed diagnosis of ATL. An ultrasonographic(US) study revealed hepatosplenomegaly and enlargement of intraabdominal lymphnodes. After chemotherapy of VP-16, ADR and MTX, US demonstrated several hypoechoic small nodules in the liver. At previous admission, similar nodules appeared in the liver during chemothrapy, and were diminished by antibiotics. This time, however, they were not diminished by antibiotics. One of them appeared as a hypoechoic nodule with a hyperechoic center presenting a "target sign". A histological study of the autopsied liver revealed that the lesion was consisted of the invasion of ATL cells. The center of the lesion showed hemorrhage and necrosis. This US finding is rare in ATL and care must be taken to differentiate from abscess.