{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T05:08:49Z","timestamp":1778389729600,"version":"3.51.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"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":[[2026,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Diagnosing adult T-cell leukemia\/lymphoma (ATLL) remains challenging due to its clinical and histopathologic heterogeneity. While HTLV-1 serology is a key diagnostic criterion, it is often unavailable at the time of diagnosis and does not confirm viral integration in tumor cells. The HTLV-1\u2013encoded HBZ RNA is a reliable diagnostic biomarker for ATLL. We evaluated the diagnostic performance of RNAscope in situ hybridization (ISH) for HBZ RNA in formalin-fixed, paraffin-embedded (FFPE) tissues to distinguish ATLL from other T-cell lymphomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>HBZ ISH was evaluated in 72 cases, including 52 ATLLs and 20 non-ATLL T-cell lymphomas, to determine diagnostic sensitivity and specificity, interobserver agreement, interlaboratory reproducibility, and comparison with digital gene expression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This assay demonstrated 86.5% sensitivity and 100% specificity, with sensitivity improving to 97% when excluding bone marrow clot sections and FFPE blocks older than 5 years. Interobserver agreement among 3 pathologists was excellent (\u03ba\u2009=\u20090.92, percent agreement: 94%). Interlaboratory reproducibility of HBZ ISH was high, with 93% to 95% concordance across these Clinical Laboratory Improvement Amendments\u2013certified laboratories. HBZ RNA ISH\u2013positive cases demonstrated significantly higher HBZ gene expression levels by digital gene expression profiling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We established HBZ ISH as a reliable tissue-based surrogate for HTLV-1 infection in ATLL. This assay will enhance diagnostic accuracy, expedite definitive diagnosis, and improve patient selection for targeted therapies and clinical trials, particularly in regions with a high prevalence of HTLV-1.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajcp\/aqag030","type":"journal-article","created":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T12:45:40Z","timestamp":1772887540000},"source":"Crossref","is-referenced-by-count":1,"title":["Real-time diagnosis of adult T-cell leukemia\/lymphoma using HBZ RNA in situ hybridization"],"prefix":"10.1093","volume":"165","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0352-5526","authenticated-orcid":false,"given":"Catalina","family":"Amador","sequence":"first","affiliation":[{"name":"University of Miami Department of Pathology and Laboratory Medicine, , Miami, FL,","place":["United States"]},{"name":"University of Miami Sylvester Comprehensive Cancer Center, , Miami, FL,","place":["United 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Pathology, Mayo Clinic , Rochester, MN,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynn C","family":"Moscinski","sequence":"additional","affiliation":[{"name":"Department of Pathology\/Hematopathology and Laboratory Medicine, Moffitt Cancer Center , Tampa, FL,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5798-5013","authenticated-orcid":false,"given":"Daniel P","family":"Cassidy","sequence":"additional","affiliation":[{"name":"University of Miami Department of Pathology and Laboratory Medicine, , Miami, FL,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J","family":"Dicaudo","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Dermatology, , Scottsdale, Arizona,","place":["United 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