Pathologic material from patients identified to be seropositive for HTLV-I is reviewed and correlated with clinical and epidemiologic features of disease. Material is derived from patients in the United States as well as other parts of the world. Where possible, immunologic phenotyping of the lymphomas is performed and tumor DNA is directly analyzed for viral genome. For cases in which fresh material is not available, DNA will be extracted from paraffin sections and examined for HTLV-I sequences using the PCR amplification technique. This information will be correlated with serologic, clinical and pathologic data to determine the validity of the PCR technique in establishing the diagnosis of adult T-cell lymphoma/leukemia (ATL). In selected populations where HTLV-I is endemic, such as Jamaica or Trinidad, prospective studies of all newly diagnosed lymphoma patients are conducted. Such studies are useful in identifying the clinicopathologic spectrum of HTLV-I associated diseases. Prospective studies of all lymphomas in similar geographic regions with differing incidences of adult T cell leukemia/lymphomas are included to discern factors which may have an impact on the incidence of HTLV-I and HTLV-I associated diseases. Other diseases are being investigated with respect to a possible viral association: angiocentric immunoproliferative disorders (lymphomatoid granulomatosis), sinus histiocytosis with massive lymphadenopathy, systemic Castleman's and Kikuchi's disease, and non-Hodgkin's lymphomas. Viruses under investigation include EBV, HHV-6, HTLV-I, and HTLV-II.
