{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:35:08Z","timestamp":1777880108686,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Infection"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Adult T-cell leukemia\/lymphoma (ATLL) is a rare, human T-lymphotropic virus type 1 (HTLV-1)\u2013driven neoplasm that is often underrecognized in low-endemic regions. We describe a 23-year-old man with an eight-year history of chronic dry cough who later developed weight loss, night sweats, odynophagia, and dyspnea. CT revealed cervical\/supraclavicular lymphadenopathy with innumerable pulmonary micronodules, interlobular septal thickening, and ground-glass opacities; abdominal imaging showed hepatosplenomegaly, ascites, and extensive retroperitoneal\/mesenteric adenopathy. HTLV-1 ELISA and confirmatory Western blot were positive. Excisional lymph node biopsy demonstrated diffuse architectural effacement by atypical T cells with a CD3+, CD4+, CD5+, CD25+, CD7\u2013, granzyme B+ immunophenotype and a ~90% Ki-67 index, establishing lymphomatous-type ATLL with a cytotoxic profile. Despite rapid recognition, the patient deteriorated and died from respiratory failure 15\u2009days after diagnosis, before chemotherapy could begin. This lung-predominant presentation in a young adult illustrates how ATLL can mimic chronic pulmonary disease and evade early detection outside endemic areas. Clinicians should prioritize early tissue acquisition and a minimal T-cell panel (CD3, CD4, CD25, CD7, Ki-67); a CD4+CD25+ phenotype with CD7 loss should prompt HTLV-1 testing irrespective of geography. Streamlined access to immunophenotyping and confirmatory HTLV-1 assays is essential to reduce diagnostic delays and improve outcomes.<\/jats:p>","DOI":"10.1177\/20499361261444136","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T02:25:28Z","timestamp":1777256728000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lymphomatous-type adult T-cell leukemia\/lymphoma associated with HTLV-1 presenting as chronic respiratory illness in a young adult: a case report"],"prefix":"10.1177","volume":"13","author":[{"given":"H. A.","family":"Nati-Castillo","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Biomateriales y Biotecnolog\u00eda\u2013BEO, Facultad de Salud, Universidad Santiago de Cali, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Ocampo-Posada","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Ciencias B\u00e1sicas y Cl\u00ednicas de la Salud, Universidad Javeriana, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jhan S.","family":"Saavedra-Torres","sequence":"additional","affiliation":[{"name":"Grupo de investigaci\u00f3n en educaci\u00f3n y Salud (GINEYSA), Facultad de Salud, Universidad Santiago de Cali, Cali, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana Cecilia","family":"Correa Gomez","sequence":"additional","affiliation":[{"name":"Unidad de Atenci\u00f3n Integral en C\u00e1ncer VIDANOVA, Popay\u00e1n, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlon","family":"Arias-Intriago","sequence":"additional","affiliation":[{"name":"Pathology Department, SOLCA Quito, Quito, Ecuador"},{"name":"One Health Research Group, Universidad de las Am\u00e9ricas, Quito, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Gaibor-Pazmi\u00f1o","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Am\u00e9ricas, Quito, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-0546","authenticated-orcid":false,"given":"Juan S.","family":"Izquierdo-Condoy","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Americas, Calle De los Colimes, Quito, Pichincha 170125, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,26]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2020.01207"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3415"},{"key":"e_1_3_4_4_2","first-page":"485","article-title":"HTLV-1 infection: an emerging risk. Pathogenesis, epidemiology, diagnosis and associated diseases","volume":"32","author":"Eusebio-Ponce E","year":"2019","unstructured":"Eusebio-Ponce E, Anguita E, Paulino-Ramirez R, et al. HTLV-1 infection: an emerging risk. Pathogenesis, epidemiology, diagnosis and associated diseases. Rev Esp Quimioter 2019; 32: 485\u2013496.","journal-title":"Rev Esp Quimioter"},{"key":"e_1_3_4_5_2","first-page":"295","article-title":"Leucemia\/Linfoma T del adulto HTLV1, un desaf\u00edo para el cl\u00ednico","volume":"20","author":"Cabrera ME","year":"2020","unstructured":"Cabrera ME, Pe\u00f1a C, Cabrera ME, et al. Leucemia\/Linfoma T del adulto HTLV1, un desaf\u00edo para el cl\u00ednico. Rev Fac Med Humana 2020; 20: 295\u2013302.","journal-title":"Rev Fac Med Humana"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2018.18038"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000026236"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp-2025-210074"},{"key":"e_1_3_4_9_2","unstructured":"Durer C Babiker HM. Adult T-cell leukemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK558968\/ (2025 accessed 21 October 2025)."},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2007.052456"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-025-07084-8"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.modpat.2023.100169"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2017.021907"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850515)55:10<2491::AID-CNCR2820551030>3.0.CO;2-I"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-99-119294"},{"key":"e_1_3_4_16_2","article-title":"Lung involvement in adult T-cell lymphoma diagnosed using bronchoscopic cryobiopsy: a case report and review of the literature","volume":"59","author":"Tanaka Y","year":"2023","unstructured":"Tanaka Y, Kido T, Sakamoto N, et al. Lung involvement in adult T-cell lymphoma diagnosed using bronchoscopic cryobiopsy: a case report and review of the literature. 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