<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2244-761X</journal-id>
<journal-title><![CDATA[Revista Digital de Postgrado]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Digit. Postgr.]]></abbrev-journal-title>
<issn>2244-761X</issn>
<publisher>
<publisher-name><![CDATA[Facultad de Medicina - Universidad Central de Venezuela, Caracas, Venezuela]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2244-761X2025000300501</article-id>
<article-id pub-id-type="doi">10.37910/rdp.2025.14.3.e439</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Leucemia/Linfoma T Seronegativa]]></article-title>
<article-title xml:lang="en"><![CDATA[T-cell leukemia/lymphoma seronegative]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[Ligia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Strocchia]]></surname>
<given-names><![CDATA[Raul]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zerpa]]></surname>
<given-names><![CDATA[Zaidith]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[Edgar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marchan]]></surname>
<given-names><![CDATA[Analiesse]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Escalona]]></surname>
<given-names><![CDATA[Lucymar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carrera]]></surname>
<given-names><![CDATA[Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Abreu]]></surname>
<given-names><![CDATA[Sonia De]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Central de Venezuela  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Central de Venezuela  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Central de Venezuela  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Central de Venezuela  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad Central de Venezuela  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Universidad Central de Venezuela  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Venezuela</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,fernandocarrera589@gmail.com  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af8">
<institution><![CDATA[,soniadeabreu13@gmail.com  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>14</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://ve.scielo.org/scielo.php?script=sci_arttext&amp;pid=S2244-761X2025000300501&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://ve.scielo.org/scielo.php?script=sci_abstract&amp;pid=S2244-761X2025000300501&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://ve.scielo.org/scielo.php?script=sci_pdf&amp;pid=S2244-761X2025000300501&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La leucemia/linfoma de células T del adulto (ATLL) es una neoplasia linfoproliferativa agresiva de linfocitos T CD4+/CD25+, asociada en más del 95 % de los casos a infección por HTLV-1, cuya seropositividad constituye un criterio diagnóstico esencial. Sin embargo, se han documentado variantes seronegativas extremadamente infrecuentes, que plantean importantes desafíos diagnósticos y terapéuticos. Presentamos el caso de una paciente femenina de 67 años con manifestaciones neurológicas atípicas como debut de ATLL: cefalea intensa, somnolencia, desorientación y signos de afectación de pares craneales (II, V, VI y VII), incluyendo hemorragias retinianas bilaterales y parestesias faciales. El líquido cefalorraquídeo evidenció hipertensión de apertura y pleocitosis linfocítica leve sin hallazgos infecciosos, y la resonancia cerebral reveló leucoencefalopatía periventricular. Durante su evolución, desarrolló leucocitosis progresiva, anemia, trombocitopenia y linfocitos atípicos &#8220;en flor&#8221; en sangre periférica. La citometría de flujo de médula ósea mostró un inmunofenotipo CD4+/CD25+/HLA-DR+ con pérdida de CD7, CD8 y CD26. Las serologías para HTLV-1 y HTLV-2 fueron repetidamente negativas. La literatura reconoce la posibilidad de ATLL seronegativo, atribuida a baja carga viral, mutaciones en epítopos o integración silenciosa del genoma viral, detectable solo por técnicas moleculares. Este caso refuerza dichas hipótesis y evidencia una forma inusual de ATLL con afectación neurológica prominente y seronegatividad persistente, lo que cuestiona los criterios diagnósticos convencionales y resalta la necesidad de enfoques moleculares avanzados para su identificación oportuna]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive lymphoproliferative malignancy of CD4+/CD25+ T lymphocytes, associated in over 95% of cases with human T-cell lymphotropic virus type 1 (HTLV-1) infection, whose seropositivity is considered an essential diagnostic criterion. However, extremely rare seronegative variants have been reported, posing significant diagnostic and therapeutic challenges. We report the case of a 67-year-old woman with atypical neurological manifestations as the initial presentation of ATLL: severe holocranial headache, somnolence, disorientation, and multiple cranial nerve involvement (II, V, VI, and VII), including bilateral retinal hemorrhages and facial paresthesias. Cerebrospinal fluid analysis showed opening pressure hypertension and mild lymphocytic pleocytosis without infectious findings. Brain MRI revealed periventricular leukoencephalopathy. During progression, the patient developed marked leukocytosis, anemia, thrombocytopenia, and atypical &#8220;flower-like&#8221; lymphocytes in peripheral blood. Bone marrow flow cytometry revealed a CD4+/CD25+/HLA-DR+ immunophenotype with loss of CD7, CD8, and CD26. Serologies for HTLV-1 and HTLV-2 were repeatedly negative. Literature supports the existence of seronegative ATLL, possibly explained by low viral load, epitope mutations, or silent viral genome integration detectable only through highly sensitive molecular techniques. This case reinforces such hypotheses and illustrates an unusual presentation of ATLL with prominent neurological involvement and persistent seronegativity, challenging traditional diagnostic criteria and emphasizing the need for advanced molecular approaches for timely recognition]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Leucemia/Linfoma de Células T del Adulto]]></kwd>
<kwd lng="es"><![CDATA[HTLV]]></kwd>
<kwd lng="es"><![CDATA[Seronegatividad]]></kwd>
<kwd lng="es"><![CDATA[Inmunofenotipo CD4+/CD25+]]></kwd>
<kwd lng="en"><![CDATA[Adult T-Cell Leukemia/Lymphoma]]></kwd>
<kwd lng="en"><![CDATA[HTLV]]></kwd>
<kwd lng="en"><![CDATA[Seronegativity]]></kwd>
<kwd lng="en"><![CDATA[CD4+/CD25+ Immunophenotype]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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