LAUSR

A 59-year-old woman was admitted for progressive ataxia and decreased consciousness, which had commenced two months previously. The patient had human immunodeficiency virus (HIV)/ human T-cell lymphotropic virus-1 (HTLV-1) co-infection for 10 years with regular use of antiretroviral therapy, resulting in satisfactory virological control (undetectable HIV load, CD4+ T lymphocyte count: 354 cells/mm3). Laboratory data revealed leukocytosis (142.3 × 109/L 78% lymphocytes, some with “flower cell” morphology [Figure 1]), hypercalcemia, elevated serum lactate dehydrogenase, FIGURE 1: Atypical lymphocytes in peripheral blood showing classical “flower cell” morphology. Leishman stain, magnification × 1000. FIGURE 2: Blood lymphocyte immunophenotyping by flow cytometry. Lymphocytes (marked by red color in dot-plots) were CD3+ (A), CD5+ (B), and CD25+ (C). D: CD3+ T-lymphocytes with CD4+/CD8phenotype (marked by pink color in dot-plots) in 97.3% of cells analyzed.