{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T15:19:01Z","timestamp":1778253541504,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["pathsocjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pathology CR"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Adult T\u2010cell leukemia\/lymphoma (ATLL) is a distinct type of peripheral T\u2010cell lymphoma (PTCL) driven by human T\u2010lymphotropic virus type I (HTLV\u20101)\u2013infected T cells, but diagnosis can be confounded by histological overlap with non\u2010ATLL PTCL. While molecular testing is the diagnostic gold standard in endemic areas, HTLV\u20101\/2 serology is often used as a surrogate in nonendemic settings, yet its accuracy and limitations remain unclear. We retrospectively analyzed 881 PTCL cases over 25\u2009years at two tertiary referral hospitals in Taiwan, where HTLV\u20101 is nonendemic. Serology was available in 48.2% of cases. Molecular confirmation was performed using\n                    <jats:italic>HBZ in situ<\/jats:italic>\n                    hybridization and\n                    <jats:italic>tax<\/jats:italic>\n                    quantitative polymerase chain reaction. Among the 44 seropositive PTCL patients with tissue available, 37 were diagnosed and molecularly confirmed as ATLL. Of the seven initially diagnosed as non\u2010ATLL PTCL, three were reclassified as ATLL, while four showed no molecular evidence, including three likely false seropositives with borderline signal\u2010to\u2010cutoff (S\/CO) values in serology assay and T follicular helper cell phenotype. In seropositive PTCL, clinicopathologic interpretation without molecular testing yielded 100% positive predictive value, 93% sensitivity, and 93% accuracy, compared with 91% positive predictive value by serology alone. In addition, retrospective molecular screening in 59 PTCL without prior serologic data revealed one case of ATLL that had initially been overlooked. In conclusion, our findings support routine HTLV\u20101\/2 serologic testing in all newly diagnosed PTCLs. However, interpretation should be guided by clinicopathological correlation and serology index values. Borderline index results warrant molecular confirmation.\n                  <\/jats:p>","DOI":"10.1002\/2056-4538.70072","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T06:25:13Z","timestamp":1767075913000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic utility and pitfalls of human T\u2010lymphotropic virus serology in adult T\u2010cell leukemia\/lymphoma: evidence from a 25\u2010year pathology\u2010based nonendemic cohort"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1438-9187","authenticated-orcid":false,"given":"Chang\u2010Tsu","family":"Yuan","sequence":"first","affiliation":[{"name":"Department and Graduate Institute of Pathology National Taiwan University Hospital and National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Department of Pathology National Taiwan University Cancer Center  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li\u2010Yu","family":"Sun","sequence":"additional","affiliation":[{"name":"Department and Graduate Institute of Pathology National Taiwan University Hospital and National Taiwan University College of Medicine  Taipei Taiwan"},{"name":"Department of Pathology National Taiwan University Cancer Center  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih\u2010Sung","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Pathology Chi\u2010Mei Medical Center  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kennosuke","family":"Karube","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Nagoya University  Aichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiao\u2010Bai","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pathology National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"},{"name":"Department of Pathology Ton\u2010Yen General Hospital  Hsinchu Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sze\u2010Hwei","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Integrated Diagnostics &amp; Therapeutics National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u2010Ching","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology China Medical University Hospital  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9665-5236","authenticated-orcid":false,"given":"Kung\u2010Chao","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pathology National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chein\u2010Jun","family":"Kao","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huai\u2010Hsuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen\u2010Chien","family":"Chou","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01620-2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015851"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16213"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910330602"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02982070"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12979"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/088922299311402"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910430618"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32556"},{"key":"#cr-split#-e_1_2_9_11_1.1","unstructured":"Health Promotion Administration Ministry of Health and Welfare Taiwan.Cancer Registry Annual Report (2020) 2022"},{"key":"#cr-split#-e_1_2_9_11_1.2","unstructured":"184-185. 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