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Mediastinal T-Cell Lymphoblastic Lymphoma: A Rare Case in a Limited Resources Setting
(1) [ScopusID: 57223083524] Department of Anatomical Pathology, Faculty of Medicine, Universitas Muhammadiyah Surabaya, Surabaya, East Java, Indonesia
(2) Department of Anatomical Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
(3) Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
(4) School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
(*) Corresponding Author
Abstract
Background: Lymphoblastic Lymphoma (LBL) is a rare neoplasm which represents 1-2% of all Non-Hodgkin’s Lymphomas (NHLs).
Objectives: To present challenges in diagnostic of a rare case in limited resources setting
Case Presentation: A 36-year-old male came to Dr. Soetomo hospital with shortness of breath, facial edema and chest pain. Physical examination revealed a decreased breath sound and dull percussion in the right chest. CT scan showed solid mass 10.4 x 5.9 x 14.6 cm in the anterior - medius of mediastinum. Fine needle aspiration biopsy guided by CT scan showed the spread of lymphoid cells, big in size, anaplastic, rounded and hyperchromatic nuclei. Core biopsy showed diffuse and monotonous pattern of pleomorphic cells, round to oval and hyperchromatic nuclei. Immunostaining were positive for CD3 and Tdt, high Ki67 proliferation index 98%, and negative for CD20.
Conclusion: T-LBL is a rare neoplasm, that generally occurs in adolescents and young adults, and is most common in males. It is an aggressive neoplasm, which can involve mediastinal mass and cause superior vena cava syndrome. Immunostaining would be positive for Tdt, and variably express CD1a, CD2, CD3, CD4, CD5, CD7, and CD8. The prognosis was poor due to the aggressiveness and the relapse.Keywords
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Bassan R, Maino E, Cortelazzo S. Lymphoblastic lymphoma: An updated review on biology, diagnosis, and treatment. Eur J Haematol. 2016;96(5):447–60.
Portell CA, Sweetenham JW. Adult Lymphoblastic Lymphoma LYMPHOMA OR LEUKEMIA OR BOTH? 2012;18(5).
He XL, Yu F, Guo T, Xiang F, Tao XN, Zhang JC, et al. T-cell lymphoblastic lymphoma presenting with pleural effusion: A case report. Respir Med Case Reports. 2014;12:55–8.
You MJ, Medeiros LJ, Hsi ED. T-lymphoblastic leukemia/lymphoma. Am J Clin Pathol. 2015;144(3):411–22.
Cortelazzo S, Ferreri A, Hoelzer D, Ponzoni M. Lymphoblastic lymphoma. Crit Rev Oncol Hematol. 2017;113:304–17.
Ioachim, H. L. and Medeiros LJ. Precursor T-cell lymphoblastic leukemia/lymphoma. In: Ioachim, H. L. and Medeiros LJ, editor. Ioachim’s Lymph Node Pathology. 4th ed. Philadelphia: Lippincott William and Wilkins; 2009. p. 334–40.
Wilson LD, Detterbeck FC, Yahalom J. Superior Vena Cava Syndrome with Malignant Causes From the Departments of Therapeutic Radiology. N Engl J Med. 2007;356:1862–9.
Borowitz, M. J., Chan, J. K. C., Bene MC., et al. T-lymphoblastic leukemia/lymphoma. In: S. H. Swerdlow, E. Campo NLH, editor. WHO Classification of tumours of hematopoietic and lymphoid tissues. 4th ed. Lyon: International Agency for Research on Cancer; 2017. p. 209–12.
Vakiani E, Savage DG, Pile-Spellman E, El-Tamer M, Singh IR, Murty VS, et al. T-cell lymphoblastic lymphoma presenting as bilateral multinodular breast masses: A case report and review of the literature. Am J Hematol. 2005;80(3):216–22.
Ellin F, Jerkeman M, Hagberg H, Relander T. Treatment outcome in T-cell lymphoblastic lymphoma in adults - A population-based study from the Swedish Lymphoma Registry. Acta Oncol (Madr). 2014;53(7):927–34.
Hoelzer D, Gökbuget N. T-cell lymphoblastic lymphoma and T-cell acute lymphoblastic leukemia: a separate entity? Clin Lymphoma Myeloma [Internet]. 2009;9 Suppl 3(September):S214–21.
Kataoka K, Nagata Y, Kitanaka A, Shiraishi Y, Shimamura T, Yasunaga JI, et al. Integrated molecular analysis of adult T cell leukemia/lymphoma. Nat Genet. 2015;47(11):1304–15.
Li B, Liu S, Yang H, Wang W. Primary T-cell lymphoblastic lymphoma in the middle ear. Int J Pediatr Otorhinolaryngol. 2016;82:19–22.
Yu JB, Wilson LD, Detterbeck FC. Superior vena cava syndrome-a proposed classification system and algorithm for management. J Thorac Oncol. 2008;3(8):811–4.
Plekker D, Ellis T, Irusen EM, Bolliger CT, Diacon AH. Clinical and radiological grading of superior vena cava obstruction. Respiration. 2008;76(1):69–75.
Carter BW, Okumura M, Detterbeck FC, Marom EM. Approaching the patient with an anterior mediastinal mass: A guide for radiologists. J Thorac Oncol [Internet]. 2014;9(9):S110–8.
Frampas E. Lymphomas: Basic points that radiologists should know. Diagn Interv Imaging [Internet]. 2013;94(2):131–44.
Otero HJ, Jagannathan JP, Prevedello LM, Johnston CJ, Ramaiya NH, Van Den Abbeele AD, et al. CT and PET/CT findings of T-cell lymphoma. Am J Roentgenol. 2009;193(2):349–58.
Bhaker P, Das A, Rajwanshi A, Gautam U, Trehan A, Bansal D, et al. Precursor T-lymphoblastic lymphoma: Speedy diagnosis in FNA and effusion cytology by morphology, immunochemistry, and flow cytometry. Cancer Cytopathol. 2015;123(9):557–65.
Lepretre S, Graux C, Touzart A, Macintyre E, Boissel N. Adult T-type lymphoblastic lymphoma: Treatment advances and prognostic indicators. Exp Hematol. 2017;51:7–16.
Dong M, Zhang X, Yang Z, Wu S, Ma M, Li Z, et al. Patients over 40 years old with precursor T-cell lymphoblastic lymphoma have different prognostic factors comparing to the youngers. Sci Rep. 2018;8(1):1–7.
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DOI: https://doi.org/10.26714/magnamed.11.2.2024.251-258
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