A Rare Case of T-cell Lymphoblastic Lymphoma: A Diagnostic Predicament

Lymphomas are the malignant neoplasms of lymphocytes and their precursor cells. Their diagnosis can sometimes be difficult due to their similarity to various other entities. A 10-year-old female reported swelling on the right side of the upper jaw for a month which was associated with mild continuous pain. On examination, a mild diffused swelling was noted on the right middle third of the face region which was firm in consistency and slightly tender. Intraorally, a firm tender swelling was noted on the right side of the hard palate. A proximal caries was noted with 55. A provisional diagnosis of dentoalveolar abscess with 55 was made. A panoramic radiograph showed loss of lamina dura concerning 11, 12, 53, 14, and 55, and loss of floor of the maxillary sinus. Cone-beam computed tomography and computed tomography-paranasal sinus revealed an ill-defined, hypodense osteolytic lesion with irregular borders extending from the 11 to 15 tooth region. Radiographic evaluation was suggestive of an infectious or neoplastic lesion. An incisional biopsy was performed and sent for histopathological and immunohistochemical analysis. A diagnosis of T-cell lymphoblastic lymphoma was made based on the features seen. The patient was sent for chemotherapy and radiotherapy. The reduction in the size of the lesion was noted on follow-up. Lymphoblastic lymphoma is a neoplasm of lymphocytes that is rarely seen in the oral cavity. Early diagnosis and prompt treatment are necessary to prevent further complications.