{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:47:26Z","timestamp":1785937646405,"version":"3.56.0"},"reference-count":63,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Human T-lymphotropic virus type 1 (HTLV-1) infection is asymptomatic in most carriers; however, approximately 5% of infected individuals may develop adult T-cell leukemia\/lymphoma (ATLL), a rare and highly aggressive malignancy with poor prognosis. We report a case of acute-type ATLL in an elderly patient from the Brazilian Amazon that was initially suspected to be T-cell lymphoblastic lymphoma, resulting in diagnostic delay. Peripheral blood and bone marrow examinations revealed marked lymphocytosis with characteristic \u201cflower cells,\u201d prompting serological testing for HTLV-1. Infection was confirmed by chemiluminescent immunoassay and western blot. The diagnosis was established at the state reference hematology center, highlighting the critical role of cytomorphologic evaluation in endemic regions where HTLV-1 remains underdiagnosed. We additionally present a narrative review of reported ATLL cases in Latin America, emphasizing the frequency of acute presentations, high mortality rates, and diagnostic challenges posed by overlapping immunophenotypic features with other aggressive T-cell neoplasms. This case underscores the importance of maintaining a high index of suspicion for HTLV-1-associated ATLL in tropical settings and reinforces the need for improved diagnostic surveillance in the Brazilian Amazon.<\/jats:p>","DOI":"10.4269\/ajtmh.26-0108","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T18:54:02Z","timestamp":1782413642000},"page":"398-405","source":"Crossref","is-referenced-by-count":0,"title":["Acute Adult T-Cell Leukemia\/Lymphoma Mimicking T-Cell Lymphoblastic Lymphoma in the Brazilian Amazon: A Case Report and Narrative Review of Latin American Cases"],"prefix":"10.4269","volume":"115","author":[{"given":"Izabela Cabral","family":"Freitas","sequence":"first","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Ci\u00eancias Aplicadas \u00e0 Hematologia, Universidade do Estado do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe Araujo","family":"Santos","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Imunologia B\u00e1sica e Aplicada, Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade Federal do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzam\u00f4r Henrique Soares","family":"Pessoa","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Imunologia B\u00e1sica e Aplicada, Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade Federal do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udio Lucas Santos","family":"Cat\u00e3o","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Imunologia B\u00e1sica e Aplicada, Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade Federal do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateus Souza","family":"Barros","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Imunologia B\u00e1sica e Aplicada, Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade Federal do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fl\u00e1via Santos","family":"Pio","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Enfermagem em Ampla Associa\u00e7\u00e3o com a Universidade Estadual do Par\u00e1\/Universidade Federal do Amazonas, Manaus, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ros\u00e2ngela Santos","family":"Abreu","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Ci\u00eancias Aplicadas \u00e0 Hematologia, Universidade do Estado do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wally Victoria Fabienne Kriger Anto","family":"Sposina","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thais Ditolvo Costa","family":"Salina","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9a Monteiro","family":"Tarrag\u00f4","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Ci\u00eancias Aplicadas \u00e0 Hematologia, Universidade do Estado do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Imunologia B\u00e1sica e Aplicada, Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade Federal do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fab\u00edola Silva","family":"Alves-Hanna","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Ci\u00eancias Aplicadas \u00e0 Hematologia, Universidade do Estado do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Imunologia B\u00e1sica e Aplicada, Instituto de Ci\u00eancias Biol\u00f3gicas, Universidade Federal do Amazonas, Manaus, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilberto Dias","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Brazil;"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Ci\u00eancias Aplicadas \u00e0 Hematologia, 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