LAUSR

Adult T-cell leukemia-lymphoma (ATLL) is a peripheral T-cell neoplasm caused by human T-cell lymphotropic virus-1 (HTLV-1) that may resemble other lymphomas clinically and histopathologically. Approximately half of patients with ATLL present with heterogeneous cutaneous findings at some point in their disease course, which are delineated by skin-first, skin-second, and skin-uninvolved courses.1, 2 With skin-first presentation, more than 80% of ATLL patients in the United States have a diagnosis of cutaneous T-cell lymphoma (CTCL).1 The rarity of ATLL in the United States, coupled with its clinicopathologic mimicry of other primary CTCLs, such as mycosis fungoides (MF) and systemic T-cell lymphomas involving the skin, causes a diagnostic challenge. Delays in diagnosis of ATLL can negatively affect patient survival, necessitating greater awareness of this disease in the United States.1