[Lymphoblastic lymphoma associated with subcutaneous nodules, intramuscular mass, pericardial effusion and peripheral...

A 14-year-old boy was admitted to Department of Pediatrics at Mie University Hospital with a 12-day history of facial cervical edema associated with venous dilatation on the upper chest wall. On admission anterior mediastinal mass was found on chest X-ray film and computed tomography. A needle biopsy revealed non-Hodgkin's lymphoma, diffuse lymphoblastic type and he was staged as III. He was treated with High-risk lymphoma protocol and achieved complete remission. At relapse he developed various manifestations unusual for lymphoblastic lymphoma including peripheral lymphadenopathy, an intramuscular mass of the lt-lower leg, multiple subcutaneous nodules at anterior chest wall and upper abdomen, and pericardial effusion. No lymphomatous infiltration into bone marrow or central nervous system was observed throughout his clinical course. Immunological phenotype of lymphoma cells from pericardial effusion was quite compatible with that of common thymocytes. However cytogenetic analysis showed unique translocation: (2; 5) (q 33; q 35). Translocations with a break at 5 q 35 have been reported in peripheral T-cell lymphoma and malignant histiocytosis.