Smoldering HTLV-associated T-cell leukemia.

Human T-cell lymphotropic virus type I-associated adult T-cell leukemia/lymphoma is a newly described clinical entity characterized by the abrupt onset of cutaneous manifestations, hypercalcemia, lymphadenopathy, and pleomorphic lobulated T cells found in the peripheral blood. The vast majority of cases reported in the United States have emphasized the rapid onset and fulminant course of the disease, which is unresponsive to conventional chemotherapeutic regimens. A smoldering form of this disease characterized by long duration of skin involvement has recently been described primarily in Japan. We describe a case of "smoldering" human T-cell lymphotropic virus type I disease in a patient from the United States.