TABLE 2.
Adult T-cell leukemia/lymphoma subtypes and diagnosis criteria
| Parametera | Criterion for ATL subtype |
|||
|---|---|---|---|---|
| Smoldering | Chronic | Lymphoma | Acute | |
| Lymphocyte count (109 lymphocytes/liter) | Less than 4 | 4 or mored | Less than 4 | More than 4 |
| % atypical lymphocytes | 5 or more | 5 or more | 1 or less | More than 5 |
| LDH level | 1.5× normal upper limit | 2× normal upper limit | —b | —b |
| Calcium level (mmol/liter) | Less than 2.74 | less than 2.74 | —b | More than 2.74b |
| Presence of: | ||||
| Lymphadenopathy | No | No | Atypical lymphocyte in histological analysis | —b |
| Skin lesions | —c | —b | —b | —b |
| Pulmonary lesions | —c | —b | —b | —b |
| Liver lesions | No | —b | —b | —b |
| Spleen lesions | No | —b | —b | —b |
| CNS lesions | No | No | —b | —b |
| Bone lesions | No | No | —b | —b |
| Ascites | No | No | —b | —b |
| Pleural effusion | No | No | —b | —b |
| Gastrointestinal tract lesions | No | No | —b | —b |
a
See reference 89.
b
Not essential.
c
Not essential; cases of atypical lymphocytes are fewer than 5%; other items have to be completed, and histological analysis of a lesion has to confirm malignancy.
d
Lymphocytosis, T-cell count of 3.5 × 109 cells/liter or more.