{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T15:13:19Z","timestamp":1785683599550,"version":"3.56.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Adult T-cell leukemia\/lymphoma (ATLL) is a rare aggressive T-cell leukemia\/lymphoma associated with human T lymphotropic virus type 1 infection. The patients might present with skin rash before, at, or after the diagnosis. The dermatopathologic finding might be diagnostically very challenging.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively identified 110 patients with ATLL at a single institution in a 19-year period, with 19 patients having skin biopsies. Clinical, dermatopathologic, immunophenotypic, and molecular findings were studied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The cohort included 13 skin-first (5 acute, 5 lymphomatous, 2 chronic, 1 smoldering), 6 skin-second (4 acute, 1 lymphomatous, 1 smoldering), and 91 patients without skin biopsy. Some nonphotoprotected areas of body such as the forearm and lower lip were also seen. Skin manifestations included papular (5), erythroderma (1), nodulotumoral (3), plaques (1), patches (1), and a combination of skin rashes (2). Histopathologic findings included large pleomorphic cells, angiocentrism, epidermal infiltration with large Pautrier-like microabscesses, and folliculotropism. Fifteen (78.9%) cases showed CD4+\/CD7\u2013\/CD25+. Next-generation sequencing study was conducted on 5 patients using either blood or bone marrow samples, revealing multiple genetic mutations across multiple signaling pathways.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Pleomorphic large, atypical cells with CD4+\/CD25+\/CD7\u2013 immunophenotype from a non\u2013\u201cbathing trunk\u201d location, especially in a patient from endemic regions, raise suspicion for ATLL. T-cell receptor gene rearrangement is almost always positive, and the neoplasm usually demonstrates multiple mutations by next-generation sequencing study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqad120","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T09:45:11Z","timestamp":1697190311000},"page":"140-148","source":"Crossref","is-referenced-by-count":6,"title":["Clinicopathologic characterization of cutaneous adult T-cell leukemia\/lymphoma: A single tertiary care center experience in the United States"],"prefix":"10.1093","volume":"161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8913-4886","authenticated-orcid":false,"given":"Mitul B","family":"Modi","sequence":"first","affiliation":[{"name":"Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY , US"},{"name":"Loyola University Chicago Stritch School of Medicine , Maywood, IL , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Kiszluk","sequence":"additional","affiliation":[{"name":"Loyola University Chicago Stritch School of Medicine , Maywood, IL , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiani N","family":"Chai","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ukuemi","family":"Edema","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxwell Y","family":"Ma","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Alejandro","family":"Sica","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7946-2843","authenticated-orcid":false,"given":"Yanhua","family":"Wang","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY , US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Shi","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center, Albert Einstein College of Medicine , Bronx, NY , US"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"2024020116351590700_CIT0001","volume-title":"WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues","author":"Swerdlow","year":"2008","edition":"4"},{"key":"2024020116351590700_CIT0002","first-page":"282","article-title":"Adult T-cell leukemia\/lymphoma","volume-title":"Arch Pathol Lab Med.","author":"Qayyum","year":"2014"},{"key":"2024020116351590700_CIT0003","first-page":"6058","article-title":"Global epidemiology of HTLV-I infection and associated diseases","volume-title":"Oncogene.","author":"Proietti","year":"2005"},{"key":"2024020116351590700_CIT0004","first-page":"19","article-title":"Skin manifestations of adult T-cell leukemia\/lymphoma: clinical, cytological and immunological features","volume-title":"J Dermatol.","author":"Tokura","year":"2014"},{"key":"2024020116351590700_CIT0005","first-page":"3961","article-title":"Type of skin eruption is an independent prognostic indicator for adult T-cell leukemia\/lymphoma","volume-title":"Blood.","author":"Sawada","year":"2011"},{"key":"2024020116351590700_CIT0006","first-page":"428","article-title":"Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma","volume-title":"Br J Haematol.","author":"Shimoyama","year":"1991"},{"key":"2024020116351590700_CIT0007","first-page":"598","article-title":"Adult T-cell leukemia\/lymphoma (ATL) presenting in the skin: clinical, histological and immunohistochemical features of 52 cases","volume-title":"Acta Oncol.","author":"Bittencourt","year":"2009"},{"key":"2024020116351590700_CIT0008","first-page":"4337","article-title":"Long-term study of indolent adult T-cell leukemia-lymphoma","volume-title":"Blood.","author":"Takasaki","year":"2010"},{"key":"2024020116351590700_CIT0009","first-page":"772","article-title":"Pathological features of diseases associated with human T-cell leukemia virus type I","volume-title":"Cancer Sci.","author":"Ohshima","year":"2007"},{"key":"2024020116351590700_CIT0010","first-page":"81","article-title":"Cutaneous manifestations of adult T-cell leukemia\/lymphoma","volume-title":"Semin Diagn Pathol.","author":"Miyashiro","year":"2020"},{"key":"2024020116351590700_CIT0011","first-page":"1046","article-title":"Adult T-cell leukemia\/lymphoma can be indistinguishable from other more common T-cell lymphomas. 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