{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T21:07:13Z","timestamp":1760044033803},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,3,7]],"date-time":"2013-03-07T00:00:00Z","timestamp":1362614400000},"content-version":"vor","delay-in-days":34,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2013,2]]},"abstract":"Adult T<\/jats:styled-content>\u2010cell leukemia\/lymphoma (ATLL<\/jats:styled-content>) is a peripheral T<\/jats:styled-content>\u2010cell neoplasm caused by human T<\/jats:styled-content>\u2010cell lymphotropic virus type I<\/jats:styled-content> (HTLV<\/jats:styled-content>\u2010I<\/jats:styled-content>). The neoplastic cells are highly pleomorphic and are usually CD<\/jats:styled-content>4+ and CD<\/jats:styled-content>8\u2212 phenotypically. We reported the case of a 46\u2010year\u2010old woman presenting with fever, abdominal distention, lymphadenopathy, leukocytosis and hypercalcemia. Nodal biopsy showed diffuse infiltration by monomorphic small to medium\u2010sized atypical lymphocytes expressing CD<\/jats:styled-content>3, CD<\/jats:styled-content>25, CD<\/jats:styled-content>30 and CD<\/jats:styled-content>99, but not CD<\/jats:styled-content>1a, CD<\/jats:styled-content>4, CD<\/jats:styled-content>8, CD<\/jats:styled-content>34, terminal deoxynucleotidyl transferase or ALK<\/jats:styled-content>. An initial diagnosis of T<\/jats:styled-content>\u2010lymphoblastic leukemia\/lymphoma was made based on cytomorphology, CD<\/jats:styled-content>4 and CD<\/jats:styled-content>8 double negativity, and the expression of CD<\/jats:styled-content>99. The diagnosis was later revised to ATLL<\/jats:styled-content> based on the positive serology study for anti\u2010HTLV I<\/jats:styled-content>\/II<\/jats:styled-content> antibody and confirmation by the clonal integration of HTLV<\/jats:styled-content>\u2010I<\/jats:styled-content> proviral DNA<\/jats:styled-content> into the tumor tissues by Southern blotting analysis. The patient had a stage IVB<\/jats:styled-content> disease and died of septic shock after 2 courses of chemotherapy 3 months after diagnosis. Immunohistochemical staining for CD<\/jats:styled-content>99 in archival ATLL<\/jats:styled-content> tissues showed a positive rate of 67% (4 of 6 tumors). Our case showed that ATLL<\/jats:styled-content> with atypical morphology and immunophenotype in HTLV<\/jats:styled-content> non\u2010endemic areas might pose a diagnostic challenge and CD<\/jats:styled-content>99 expression is frequent in ATLL<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/pin.12040","type":"journal-article","created":{"date-parts":[[2013,3,7]],"date-time":"2013-03-07T08:57:00Z","timestamp":1362646620000},"page":"132-137","source":"Crossref","is-referenced-by-count":7,"title":["CD<\/scp>4 and CD<\/scp>8 double\u2010negative adult T<\/scp>\u2010cell leukemia\/lymphoma with monomorphic cells expressing CD<\/scp>99: A diagnostic challenge in a country non\u2010endemic for human T<\/scp>\u2010cell leukemia virus"],"prefix":"10.1111","volume":"63","author":[{"given":"Tsung\u2010Hsien","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pathology Chi\u2010Mei Medical 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