Snapshot A 50-year-old man originally from the Carribean islands complains of weakness and chronic constipation. He has an erythematous rash covering > 90% of his body surface area, with well-demarcated papules as well as purpuric lesions. He is also found with hepatosplenomegaly and lymphadenopathy. A peripheral blood smear reveals “flower” cells. Introduction ATLL is an aggressive mature T-cell malignancy login to view 1 more bullet Pathogenesis login to view 1 more bullet Epidemiology login to view 6 more bullets Characteristic finding is “flower” cell on peripheral blood smear Presentation Symptoms login to view 7 more bullets Physical exam login to view 5 more bullets Evaluation Complete blood count > 5% abnormal lymphocytes Peripheral blood smear with “flower” cells Serology login to view 1 more bullet Hypercalcemia Flow cytometry or immunohistochemistry login to view 1 more bullet Imaging for lytic lesions Differential Diagnosis Mycosis fungoides Sézary syndrome Cutaneous metastases of other malignancy Treatment Zidovudine INFα Chemotherapy Prognosis, Prevention, and Complications Prognosis login to view 2 more bullets Prevention login to view 3 more bullets Complications login to view 2 more bullets