Precursor T-Lymphoblastic Lymphoma Presenting With a Cough: A Case Report

Area of Science:

• Oncology
• Hematology
• Pathology

Background:

• Lymphoblastic lymphoma (LBL) is a rare non-Hodgkin lymphoma (NHL), with precursor T-lymphoblastic lymphoma (T-LBL) accounting for the majority of cases.
• T-LBL typically affects adolescents and young adults, often presenting with symptoms related to rapid tumor growth and organ compression.

Observation:

• A 17-year-old male presented with a one-month history of productive cough, dyspnea, and chest pain.
• Clinical examination revealed left-sided cervical lymphadenopathy.
• CT pulmonary angiogram demonstrated a mediastinal mass involving perivascular, pretracheal, paratracheal, and subcranial spaces, suggestive of lymphoma.

Findings:

• Histopathology initially suggested non-Hodgkin lymphoma (NHL).
• Immunohistochemistry confirmed the diagnosis as precursor T-lymphoblastic lymphoma (T-LBL).
• The patient's presentation with a cough as a primary symptom was considered unique for T-LBL.

Implications:

• This case highlights the importance of thorough clinical evaluation and diagnostic investigations for rare hematologic malignancies.
• Recognizing atypical presentations of T-LBL is crucial for timely diagnosis and effective treatment planning.
• Comprehensive workup is essential for achieving favorable outcomes in patients with lymphoblastic lymphoma.