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Fine needle aspiration biopsy of precursor B-cell lymphoblastic lymphoma presenting as a sacral mass. A case report
Amobi M Ezenekwe1, Brian T Collins, T Brent Ponder
1Department of Pathology, Saint Louis University, St. Louis, Missouri, USA.
Background:
Lymphoblastic lymphoma (LBL) is a high grade, aggressive neoplasm, usually presenting in children and young adults. Precursor B-cell LBL is uncommon and may present with cutaneous or, less likely, bone lesions. This case represents the first reported presentation of LBL as a sacral lesion and was only the second fine needle aspiration biopsy (FNAB) of LBL presenting as a bony mass.
Case:
A 50-year-old man presented with a 3-month history of a 7 x 5 x 4-cm mass in the sacral region. The mass was radiologically described as an expansile one with lytic bone destruction. Diagnosis of a chordoma was radiologically favored. Computed tomography (CT)-guided FNAB, with flow cytometry and cytochemical staining, was used to make the diagnosis of precursor B-cell LBL.
Conclusion:
FNAB was instrumental in reaching this unusual diagnosis in a patient who was free of disease after chemotherapy.