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Unusual Presentation of Pre-T Cell Acute Lymphoblastic Leukemia: Massive Pericardial Effusion Only

Rahmi Ozdemir1, Timur Meşe, Cem Karadeniz

  • 1From the Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, Izmir, Turkey.

Pediatric Emergency Care
|July 17, 2015
PubMed

Insights

Pericardial effusion in children is rare but can indicate underlying malignancy, even without typical blood involvement. This case highlights pre-T cell acute lymphoblastic leukemia presenting solely with pericardial effusion.

Area of Science:

  • Pediatric Oncology
  • Cardiology
  • Hematology

Background:

  • Pericardial effusions in children are typically caused by infectious or connective tissue diseases.
  • Malignancy-related pericardial effusions are a rare but serious complication, often associated with advanced pediatric cancers or their treatment (chemotherapy, radiotherapy).

Observation:

  • A pediatric patient presented with significant pericardial effusion.
  • Initial investigations did not reveal typical signs of leukemia in peripheral blood.
  • The effusion was the primary presenting symptom.

Findings:

  • The patient was diagnosed with pre-T cell acute lymphoblastic leukemia (pre-T ALL).
  • This diagnosis was made despite the absence of leukemia cells in the peripheral blood.
  • Pericardial involvement was the sole presenting manifestation of the malignancy.

Implications:

  • This case underscores the importance of considering malignancy in pediatric patients with unexplained pericardial effusion, even in the absence of hematological abnormalities.
  • Early recognition of rare presentations of pediatric leukemia is crucial for timely diagnosis and treatment.
  • Highlights the need for comprehensive diagnostic workups in pediatric pericardial effusions.

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