Muscle weakness in extremities and diffuse centrilobular nodules in lungs

Lung miliary micro‐nodules in human T‐cell leukemia virus type I carriers

“…Fujii et al . reported a case similar to our series in which they emphasized that the features of granuloma seen in the reported case are different from sarcoidosis . As they indicated in their report, granulomas seen in our series were loose and associated with numerous lymphocytosis showing damage of vascular wall.…”

Human T-cell Lymphotropic Virus Type-1-associated Bronchioloalveolar Disorder with Non-necrotizing Granulomas: A Case Report and Literature Review

“…In a pathological study of pulmonary lesions in HTLV-1 carriers, a comparison of CT and pathology in 58 cases showed that centrilobular nodules and thickening of bronchovascular bundles pathologically corresponded to lymphocytic infiltration around the respiratory bronchioles and along the bronchovascular bundles, whereas ground-glass opacities corresponded to lymphocytic infiltration of the interstitium (2). However, similar to the present case, several cases of pathologically non-necrotizing granulomas in HABA with miliary nodules on CT have been reported (4,5,7,8). A summary of the clinical, CT, and pathological findings of the previously reported cases and the present case is shown in Table . Most patients were elderly (65-85 years old), with no significant differences in frequency between men and women.…”

“…We encountered a case of HABA with diffuse miliary opacities on HRCT and pathological findings of nonnecrotizing granulomas. To our knowledge, this is the seventh such case reported (4,5,7,8), and it is considered a rare form of HABA. In a report on CT findings in 320 HTLV-1 carriers, 30.1% had abnormal findings in the lung field, including centrilobular nodules (29.7%), thickening of the bronchovascular bundles (17.2%), ground-glass opacity (15.9%), bronchiectasis (15.6%), and interlobular septal thickening (8.8%) (2).…”

“…A summary of the clinical, CT, and pathological findings of the previously reported cases and the present case is shown in Table . Most patients were elderly (65-85 years old), with no significant differences in frequency between men and women. An increased BALF CD4/ CD8 ratio was observed in four of the five cases (5,7). Since the CD4/CD8 ratio was generally not increased in the BAL findings of HABA cases (10), the increased CD4/CD8 ratio may be a feature of HABA with granuloma formation, while also making it difficult to differentiate from pulmonary sarcoidosis.…”

“…The common feature of the CT findings in these cases was the diffuse presence of micronodules, although their distribution varied, with each report describing random (i.e. miliary) (4,5), centrilobular (7), or peribronchovascular and perilobular patterns (8). Pathologically, the most common feature was a lymphocytic infiltrate containing non-necrotizing granulomas, which may correspond to micronodules on CT.…”