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Given the favourable prognosis of patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, treatment-related toxicity should be minimised. We aimed to evaluate the efficacy of 4 Gy radiotherapy given in a response-adapted approach.

Visual behavior depends on both bottom-up mechanisms, where gaze is driven by the visual conspicuity of the stimuli, and top-down mechanisms, guiding attention towards relevant areas based on the task or goal of the viewer. While this is well-known, visual attention models often focus on bottom-up mechanisms. Existing works have analyzed the effect of high-level cognitive tasks like memory or visual search on visual behavior; however, they have often done so with different stimuli, methodology, metrics and participants, which makes drawing conclusions and comparisons between tasks particularly difficult. In this work we present a systematic study of how different cognitive tasks affect visual behavior in a novel within-subjects design scheme. Participants performed free exploration, memory and visual search tasks in three different scenes while their eye and head movements were being recorded. We found significant, consistent differences between tasks in the distributions of fixations, saccades and head movements. Our findings can provide insights for practitioners and content creators designing task-oriented immersive applications.

Understanding human visual behavior within virtual reality environments is crucial to fully leverage their potential. While previous research has provided rich visual data from human observers, existing gaze datasets often suffer from the absence of multimodal stimuli. Moreover, no dataset has yet gathered eye gaze trajectories (i.e., scanpaths) for dynamic content with directional ambisonic sound, which is a critical aspect of sound perception by humans. To address this gap, we introduce D-SAV360, a dataset of 4,609 head and eye scanpaths for 360° videos with first-order ambisonics. This dataset enables a more comprehensive study of multimodal interaction on visual behavior in virtual reality environments. We analyze our collected scanpaths from a total of 87 participants viewing 85 different videos and show that various factors such as viewing mode, content type, and gender significantly impact eye movement statistics. We demonstrate the potential of D-SAV360 as a benchmarking resource for state-of-the-art attention prediction models and discuss its possible applications in further research. By providing a comprehensive dataset of eye movement data for dynamic, multimodal virtual environments, our work can facilitate future investigations of visual behavior and attention in virtual reality.

A remarkable amount of new information has been generated on peritoneal mesothelioma (PeM), ranging from nomenclature changes, including the removal of “malignant” when referring to this neoplasm and the use of the term “tumor” rather than “mesothelioma” to designate the neoplasm formerly known as “well-differentiated papillary mesothelioma”, to the acknowledgment that PeMs can be associated with tumor predisposition syndromes or germline mutations. Although the disease is still more frequently seen in caucasian males, PeM is not uncommon in women. In addition, it can represent a diagnostic challenge when it has an uncommon presentation (ie, paraneoplastic syndrome or incidental finding) or when it has confounding histologic features. Ancillary testing, including immunohistochemical stains, in situ hybridization for CDKN2Aor NF2, and molecular studies, in selected cases, allows its correct diagnosis. The molecular landscape of PeM is still a work in progress; however, some findings, such as ALKgene rearrangements and EWSR1/FUS-ATF1fusions, are specifically seen in PeM of young patients. The biological behavior of PeM is variable; however, cytoreductive surgery and hyperthermic intraperitoneal chemotherapy have markedly improved the survival of patients affected by this disease.

Extrauterine mesonephric-like carcinoma (ExUMLC) shares histologic, immunohistochemical (IHC), and molecular (MOL) features with endometrial mesonephric-like carcinoma (EnMLC). Its rarity and histologic overlap with Mullerian carcinomas contribute to underrecognition of ExUMLC. Aggressive behavior of EnMLC is well-documented; behavior of ExUMLC is yet to be characterized. This study presents the clinicopathologic, IHC, and MOL features of 33 ExUMLC identified over a 20-year time period (2002-2022) and compares the behavior of this cohort to more common upper gynecologic Mullerian carcinomas (low-grade endometrioid, LGEC; clear cell, CCC; high-grade serous, HGSC) and EnMLC diagnosed over the same time period. ExUMLC patients ranged from 37 to 74 years old (median=59 y); 13 presented with advanced stage (FIGO III/IV) disease. Most ExUMLC had the characteristic mixture of architectural patterns and cytologic features, as previously described. Two ExUMLC had sarcomatous differentiation, 1 with heterologous rhabdomyosarcoma. Twenty-one ExUMLC (63%) had associated endometriosis, and 7 (21%) arose in a borderline tumor. In 14 (42%) cases, ExUMLC was part of a mixed carcinoma representing >50% of the tumor in 12. Twenty-six cases (79%) were incorrectly classified as follows: LGEC or HGEC (12); adenocarcinoma, not otherwise specified (3); HGSC (3); LGSC (2); mixed carcinoma (1); carcinosarcoma, Mullerian type (2); seromucinous carcinoma (1); transitional pattern of HGSC (1); and female adnexal tumor of probable Wolffian origin (1). Three patients had occult synchronous endometrial LGEC. IHC facilitated diagnosis in all cases with an expression of GATA-3 and/or TTF-1 in conjunction with decreased hormone receptor expression in most tumors. MOL testing (n=20) identified a variety of mutations, most frequently: KRAS(15); TP53(4); SPOP(4); and PIK3CA(4). ExUMLC and CCC were more likely to be associated with endometriosis (P<0.0001). ExUMLC and HGSC had more recurrences compared with CCC and LGEC (P<0.0001). Histologic subtype was associated with longer disease-free survival for LGEC and CCC versus HGSC and ExUMLC (P<0.001). ExUMLC trended towards a similar poor overall survival as HGSC compared with LGEC and CCC, and EnMLC trended to shorter survival compared with ExUMLC. Neither finding reached significance. No differences were seen between EnMLC and ExUMLC with respect to presenting stage or recurrence. Staging, histotype, and endometriosis were associated with disease-free survival, but on multivariate analysis, only stage remained as an independent predictor of outcome. The tendency of ExUMLC to present at an advanced stage and have distant recurrence points to more aggressive behavior compared with LGEC with which it is most frequently confused, underscoring the importance of an accurate diagnosis.

The move toward consistent and comprehensive surgical pathology reports for cancer resection specimens has been a key development in supporting evidence-based patient management and consistent cancer staging. The International Collaboration on Cancer Reporting (ICCR) previously developed a data set for reporting of the ovarian, fallopian tube and primary peritoneal carcinomas which was published in 2015. In this paper, we provide an update on this data set, as a second edition, that reflects changes in the 2020 World Health Organization (WHO) Classification of Female Genital Tumours as well as some other minor modifications. The data set has been developed by a panel of internationally recognized expert pathologists and a clinician and consists of “core” and “noncore” elements to be included in surgical pathology reports, with detailed commentary to guide users, including references. This data set replaces the widely used first edition, and will facilitate consistent and accurate case reporting, data collection for quality assurance and research, and allow for comparison of epidemiological and pathologic parameters between different populations.

Localized malignant peritoneal mesothelioma is a rare tumor with limited information in the literature. In this study, we present our experience with 18 cases seen in our hospital over a period of 43 years (1978 to 2021). Patients’ median age was 55 years (y) (range: 33 to 79 y) and most of them were Caucasians. Patients presented with abdominal pain (11), ascites and right leg swelling (1), abdominal mass (1), and as incidental finding (1). Thirty percent of patients reported asbestos exposure, and all patients with available information had family history of tumors; a third had personal history of tumors. Seventy-seven percent had some form of abdominopelvic surgery and/or inflammatory process. Most cases had microscopic features typically seen in malignant mesothelioma; however, some cases had confounding features such as signet-ring cells, spindle cells, clear cell changes, and adenomatoid tumor-like appearance. BAP-1 by immunohistochemistry was lost in 1/3 cases. Only 1 patient underwent genetic testing and had an MSH2germline mutation. Homozygous deletion of CDKN2Aby FISH was not found in 1 tested case, although next-generation sequencing identified a CDKN2Apathogenic mutation. 16/18 (88%) had surgical treatment, and some also received adjuvant chemotherapy. The mean overall survival (OS) of our patients was 80.4 months (95% confidence interval: 54.3-106.52); the 3-year OS was 79%, while the 5-year OS was 52.6%. Fifty-three percent of patients had recurrences and 20% had tumor progression. Although the limited sample precludes definitive conclusions, small tumor size, low-grade cytology, and low mitotic index appeared to be associated with an indolent behavior.

A recently developed hybrid joining process known as ultrasonic resistance spot welding (URW) was used on various pairs of similar and dissimilar aluminum (Al) alloys with different thicknesses, including AA5182-AA5182, AA6111-AA6111, AA7075-AA6111, and AA7075-AA5182, and comprehensively studied. Compared to conventional resistance spot welding (RSW), URW of the alloys showed consistently enhanced mechanical behavior in lap shear and cross-tension tests. This can be attributed to the multiple perspectives on microstructure improvements. For different stacks of Al alloys and welding conditions, nugget formation was promoted with a larger nugget size in URW. In the nugget center, ultrasonically assisted (UA) vibration facilitated the formation of an equiaxed crystal zone. At the nugget boundary, URW showed a narrower coarse columnar zone and partially melted zone, which are associated with the lowest hardness in the weld. Specifically in dissimilar Al welds, UA vibration moved the nugget more centered toward the weld interface. These microstructure improvements indicated UA vibration can homogenize temperature and elemental distribution, which modifies solidification behavior. [ABSTRACT FROM AUTHOR]

The experience with uterine inflammatory myofibroblastic neoplasms with an unfavorable outcome is limited. We present the clinicopathologic features of 9 such cases, including 8 inflammatory myofibroblastic tumors (IMTs) and 1 epithelioid inflammatory myofibroblastic sarcoma (EIMS). Median patient age for the IMT group was 50.5 years; the patient with EIMS was 43 years old. Patients presented with abnormal uterine bleeding, presumed fibroids, pelvic pain, arthralgia and low-grade fever, as well as an incidental finding. Median tumor size for the IMTs was 8.5 cm. The borders were either infiltrative or well-circumscribed. Histologically, IMTs were purely fascicular or myxoid or showed predominance of one or the other pattern. Seven tumors were spindled, and 1 was both spindled and epithelioid. Tumors had variable nuclear atypia, ranging from grade 1 to 3. All tumors had an inflammatory infiltrate-predominantly lymphocytic, majority had necrosis (62.5%) and none had lymphovascular invasion. 7/8 (87.5%) tumors were positive for ALK-1 by immunohistochemistry (IHC). One tumor was negative for ALK-1 by IHC but was positive for ALKfusion by fluorescence in situ hybridization and had TNS1-ALKfusion by next-generation sequencing (NGS). Three other tumors with NGS testing showed one of the following ALK-fusion partners: FN1, DCTN1, and IGFBP5.The EIMS had infiltrative borders, myxoid and hyalinized patterns, epithelioid cells, and no lymphovascular invasion. This tumor was ALK-1 positive by IHC, had ALKrearrangement by fluorescence in situ hybridization and RANBP2-ALKfusion by NGS. Extrauterine disease at time of diagnosis was noted in 2/8 (25%) of IMTs, and in the single case of EIMS. Seven patients had surgery as primary treatment, 1 patient had neoadjuvant chemotherapy and 1 patient declined treatment. Patients with recurrence were treated with a combination of chemotherapy, targeted therapy, radiotherapy or hormonal therapy. Most patients (71.4%) recurred within 24 months (mos). Two thirds of patients were alive with disease at last follow up (mean 43.6 mos). The patient with EIMS was alive with disease at 22 mos. IMT referral cases were initially diagnosed as smooth muscle tumors in 87.5% of cases; while the EIMS was diagnosed as high-grade endometrial stromal sarcoma. Lack of consideration of IMT in the differential diagnosis of smooth muscle tumors with myxoid features can result in misdiagnosis and under-utilization of targeted therapy in these patients.

Background: Diabetes mellitus (DM) is a metabolic and chronic disorder which causes high blood glucose concentrations and dysfunctional pancreatic beta-cells characterized by decreased insulin secretion and signalling. Scientific evidence suggests that vitamin D supplementation may help patients with type 2 diabetes mellitus (T2DM) improve glycaemic control, increase insulin secretion and decrease HbA1c concentrations. Additionally, this supplementation improves antioxidant enzyme concentrations, such as superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT) and total antioxidant capacity (TAC). Finally, some studies have reported that supplementation decreases oxidative markers such as malondialdehyde (MDA). Objective: The objective of this study is to review the effect of vitamin D supplementation on glycaemic control and oxidative stress markers in patients with T2DM. Inclusion criteria involved adult patients with T2DM, oral vitamin D supplementation with different dosages and undefined time. Studies including children or animals and with other pathologies were excluded. Methods: This systematic review was conducted following Reporting Items for Systematic Reviews and Meta-Analyses framework (PRISMA) in terms of study selection, data collection, data analysis, and result reporting. Several databases were reviewed from 2013 to 2020: Google Scholar, REDALYC, Scielo, Scopus and PubMed, among others; word combinations and MeSH keywords were used to find scientific evidence on vitamin D supplementation in patients with T2DM and their relationship with oxidative stress. Results: After making a careful selection of the studies according to its title and abstract, 120 articles were selected for reading the full text. Consequently, 21 studies and 1 report were included in this review, including systematic reviews and meta-analyses. Conclusion: Supplementation with vitamin D may help decrease glucose, and glycosylated haemoglobin and improve insulin secretion. Subjects with T2DM have higher oxidative stress concentrations and lower antioxidants than healthy subjects; vitamin D supplementation may help improve oxidative and antioxidant markers.

Adult T-cell Leukemia/Lymphoma (ATLL) is a rare and aggressive malignancy caused by the human T-cell leukemia virus type 1 (HTLV-1). ATLL carries a dismal prognosis given early relapses and a low durable remission rate. When feasible, hematopoietic stem cell transplantation (HSCT) is pursued to maximize chances for cure and long-term survival. A recent meta-analysis affirmed the utility of allo-HSCT, reporting complete remission (CR) rates of 70%, overall survival (OS) rates of 40%, and progression-free survival (PFS) rates of 37% at 3 years (Iqbal, 2019). However, most data in ATLL consists of Japanese populations. There is limited data on the Afro-Caribbean and Latin American population which is more commonly encountered in the USA and Europe.

Breast implant anaplastic large cell lymphoma (ALCL) is a T-cell neoplasm arising around textured breast implants that was recognized recently as a distinct entity by the World Health Organization. Rarely, other types of lymphoma have been reported in patients with breast implants, raising the possibility of a pathogenetic relationship between breast implants and other types of lymphoma. We report eight cases of Epstein–Barr virus (EBV)-positive large B-cell lymphoma associated with breast implants. One of these cases was invasive, and the other seven neoplasms were noninvasive and showed morphologic overlap with breast implant ALCL. All eight cases expressed B-cell markers, had a non-germinal center B-cell immunophenotype, and were EBV+ with a latency type III pattern of infection. We compared the noninvasive EBV+ large B-cell lymphoma cases with a cohort of breast implant ALCL cases matched for clinical and pathologic stage. The EBV+ large B-cell lymphoma cases more frequently showed a thicker capsule, and more often were associated with calcification and prominent lymphoid aggregates outside of the capsule. The EBV+ B-cell lymphoma cells were more often arranged within necrotic fibrinoid material in a layered pattern. We believe that this case series highlights many morphologic similarities between EBV+ large B-cell lymphoma and breast implant ALCL. The data presented suggest a pathogenetic role for breast implants (as well as EBV) in the pathogenesis of EBV+ large B-cell lymphoma. We also provide some histologic findings useful for distinguishing EBV+ large B-cell lymphoma from breast implant ALCL in this clinical setting.

Breast implant anaplastic large cell lymphoma (ALCL) is a T-cell neoplasm arising around textured breast implants that was recognized recently as a distinct entity by the World Health Organization. Rarely, other types of lymphoma have been reported in patients with breast implants, raising the possibility of a pathogenetic relationship between breast implants and other types of lymphoma. We report eight cases of Epstein–Barr virus (EBV)-positive large B-cell lymphoma associated with breast implants. One of these cases was invasive, and the other seven neoplasms were noninvasive and showed morphologic overlap with breast implant ALCL. All eight cases expressed B-cell markers, had a non-germinal center B-cell immunophenotype, and were EBV+ with a latency type III pattern of infection. We compared the noninvasive EBV+ large B-cell lymphoma cases with a cohort of breast implant ALCL cases matched for clinical and pathologic stage. The EBV+ large B-cell lymphoma cases more frequently showed a thicker capsule, and more often were associated with calcification and prominent lymphoid aggregates outside of the capsule. The EBV+ B-cell lymphoma cells were more often arranged within necrotic fibrinoid material in a layered pattern. We believe that this case series highlights many morphologic similarities between EBV+ large B-cell lymphoma and breast implant ALCL. The data presented suggest a pathogenetic role for breast implants (as well as EBV) in the pathogenesis of EBV+ large B-cell lymphoma. We also provide some histologic findings useful for distinguishing EBV+ large B-cell lymphoma from breast implant ALCL in this clinical setting.

Realizar una escala con parámetros clínicos y radiológicos precoces tras un TCE que identifique a los enfermos que en su evolución posterior van a someterse a una CD.

Realizar una escala con parámetros clínicos y radiológicos precoces tras un TCE que identifique a los enfermos que en su evolución posterior van a someterse a una CD. Estudio observacional de una cohorte retrospectiva de pacientes que tras un TCE ingresan en la Sección de Neurocríticos del Servicio de Medicina Intensiva de nuestro hospital durante un periodo de 5 años (2014-2018). Detección de variables clínicas y radiológicas y creación de todos los modelos posibles con las variables significativas, clínicamente relevantes y de fácil detección precoz. Selección del que presentaba valores más bajos de criterios de información bayesiano y de Akaike para la creación de la escala. Calibración y validación interna mediante la prueba de bondad de ajuste de Hosmer-Lemeshow y análisis bootstrapping con 1.000 re-muestreos. Se realizaron 37 CD en 153 enfermos que ingresaron tras un TCE. El modelo final resultante incluía desviación de línea media, GCS y colapso ventricular con un área bajo la curva ROC de 0,84 (IC95% 0,78-0,91) y Hosmer-Lemeshow p = 0,71. La escala desarrollada detectaba bien a los enfermos que iban a precisar una CD precoz (en las primeras 24 horas) tras un TCE (2,5 ± 0,5) pero no a aquellos que la necesitarían en una fase más tardía de su enfermedad (1,7 ± 0,8). Sin embargo, parece prevenirnos sobre los enfermos que si bien no precisan inicialmente una CD sí tienen probabilidades de necesitarla posteriormente en su evolución (CD tardía vs. no precisan CD, 1,7 ± 0,8 vs. 1 ± 0,7; p = 0,002). Hemos desarrollado una escala pronóstica que permite detectar en nuestro medio, con una buena sensibilidad y especificidad y usando criterios clínico-radiológicos precoces, aquellos pacientes que tras un TCE van a precisar una CD. To perform a score with early clinical and radiological findings after a TBI that identifies the patients who in their subsequent evolution are going to undergo DC. Observational study of a retrospective cohort of patients who, after a TBI, enter the Neurocritical Section of the Intensive Care Unit of our hospital for a period of 5 years (2014-2018). Detection of clinical and radiological criteria and generation of all possible models with significant, clinically relevant and easy to detect early variables. Selection of the one with the lowest Bayesian Information Criterion and Akaike Information Criterion values for the creation of the score. Calibration and internal validation of the score using the Hosmer-Lemeshow and a bootstrapping analysis with 1,000 re-samples respectively. 37 DC were performed in 153 patients who were admitted after a TBI. The resulting final model included Cerebral Midline Deviation, GCS and Ventricular Collapse with an Area under ROC Curve: 0.84 (95% IC 0.78-0.91) and Hosmer-Lemeshow p = 0.71. The developed score detected well those patients who were going to need an early DC (first 24 hours) after a TBI (2.5 ± 0.5) but not those who would need it in a later stage of their disease (1.7 ± 0.8). However, it seems to advice us about the patients who, although not requiring an early DC are likely to need it later in their evolution (DC after 24 hours vs do not require DC, 1.7 ± 0.8 vs 1 ± 0.7; p = 0.002). We have developed a prognostic score using early clinical-radiological criteria that, in our environment, detects with good sensitivity and specificity those patients who, after a TBI, will require a DC. [ABSTRACT FROM AUTHOR]

Malignant mesothelioma of the peritoneum in women is an uncommon tumor. In this study, we present the clinicopathologic features of 164 such cases seen in our institution over a period of 42 years (1974-2016). Clinical information, pathologic findings, immunohistochemical results, and follow-up were recorded. Hematoxylin and eosin–stained slides were reviewed in all cases. Patients ranged in age from 3 to 85 years, median: 49 years. Most patients presented with abdominal/pelvic pain, although some were asymptomatic, presented with paraneoplastic syndromes or cervical lymphadenopathy. Overall, 9% of patients had a history of direct or indirect exposure to asbestos. In total, 31% and 69% of patients had either a personal or family history of other tumors; most of these tumors are currently recognized as part of a syndrome. Genetic testing information was available in 5 patients: BAP-1germline mutation (1), type 2 neurofibromatosis (1), Lynch syndrome (1), McCune-Albright syndrome (1), no BAP-1or TP53mutation (1). Most cases had gross and microscopic features typical of malignant mesothelioma of the peritoneum in women; however, some had confounding features such as gelatinous appearance, signet ring or clear cells, and well-differentiated papillary mesothelioma-like areas. Calretinin and WT-1 were the markers more frequently expressed, and up to 23% of the cases showed PAX-8 expression. Patients’ treatments predominantly included: chemotherapy, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy. On multivariate analysis, the predominance of deciduoid cells, nuclear grade 3, and the absence of surgical treatment were associated with worse overall survival (OS). For all patients, the 3- and 5-year OS were 74.3% and 57.4%, respectively. The 3- and 5-year OS for patients treated with cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy were 88.9% and 77.8%, respectively.

Corticosteroids constitute a first-line therapy for adults and children suffering from nonmalignant immune-mediated hematologic diseases. However, high disease relapse rates during the tapering period or upon drug discontinuation result in long-term corticosteroid use that increases the risk of infection. This same concept applies to other immunosuppressive agents, such as antimetabolites, calcineurin inhibitors, and cyclophosphamide. Corticosteroids are associated with a length-of-treatment and dose-dependent risk for infection. Screening and antimicrobial prophylaxis against tuberculosis, hepatitis B, Strongyloides stercoralis, and Pneumocystis jirovecii pneumonia (PJP) might be indicated in patients who are scheduled to be on high-dose corticosteroids for >4 weeks (>30 mg of prednisone-equivalent dose [PEQ]) or in patients chronically treated (≥8 weeks of continuous or intermittent corticosteroid use) with moderate doses (≥15 to <30 mg PEQ). Antimetabolites (azathioprine, mycophenolate) increase the risk of progressive multifocal leukoencephalopathy (PML); however, other opportunistic infections and viral reactivation have also been reported. In case of new onset of neurological symptoms, PML needs to be considered, and an urgent neurology consultation should be obtained. Cyclophosphamide-induced myelosuppression can lead to serious infections related to neutropenia. PJP prophylaxis should be considered with combination therapy of cyclophosphamide and corticosteroids until a PEQ dose ≤ 5 mg/d is reached. Data on infectious risk when cyclosporine is used in patients with nonmalignant hematologic diseases are lacking. Discontinuation of any immunosuppressive agent during an episode of infection is recommended. In all patients, adherence to an age-based immunization schedule is appropriate.

Peña: Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sandoz: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees; Amgen: Speakers Bureau; BindingSite: Research Funding. Idrobo:Amgen: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau; Tecnofarma: Honoraria, Speakers Bureau; Takeda: Honoraria, Speakers Bureau; Abbvie: Honoraria, Speakers Bureau. Altamirano:Hospital Nacional Guillermo Almenara Irigoyen: Other: Servicio de Hematologia. Perini:Abbvie: Speakers Bureau; Janssen: Honoraria, Speakers Bureau; Takeda: Honoraria. Castillo:Janssen: Consultancy, Research Funding; Abbvie: Research Funding; TG Therapeutics: Research Funding; Kymera: Consultancy; Pharmacyclics: Consultancy, Research Funding; Beigene: Consultancy, Research Funding. Ramos:NIH: Research Funding. Villela:Roche: Other: advisory board, Speakers Bureau; amgen: Speakers Bureau.

INTRODUCTION:Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell neoplasm caused by the Human T-cell Leukemia Virus Type 1 (HTLV-1). HTLV-1 infects up to 10 million people worldwide and is most endemic in Southwestern Japan, Western Africa, the Caribbean basin and South America. Cutaneous signs of ATLL are varied and may consist of macules (M), plaques (P), multiple papules (MP), tumoral nodules (TN), erythroderma (E) or mixed-lesions (≥2 predominant lesions, ML). M and P forms are believed to carry a better prognosis. However, data on cutaneous presentation of ATLL remains scarce. Herein, we report cases of ATLL with cutaneous involvement diagnosed in 4 Latin American countries over the last 3 decades.

INTRODUCTION:Adult T-cell leukemia/lymphoma (ATLL) is a mature peripheral T-cell neoplasm caused by the Human T-cell Leukemia Virus Type 1 (HTLV-1). HTLV-1 infects up to 10 million people worldwide and is most endemic in Southwestern Japan, the Caribbean basin, South America, and Western Africa. In Latin America (LA), Peru and Brazil have the highest prevalence of HTLV-1-related diseases, however, data on ATLL in other LA countries is scarce. ATLL carries a dismal prognosis and is essentially incurable by conventional drugs. We describe the epidemiology, clinical features, treatment, and disease outcome of ATLL encountered in 11 countries in LA.