B-Lymphoblastic Lymphoma Presenting With a Facial Mass as the Initial Symptom

Area of Science:

• Pediatric Oncology
• Dermatology
• Hematology

Background:

• B-lymphoblastic lymphoma (B-LBL) is an aggressive malignancy primarily affecting children.
• Cutaneous B-LBL can present insidiously, often mimicking benign inflammatory conditions.
• Early and accurate diagnosis is critical for effective management and improved patient outcomes.

Purpose of the Study:

• To report a case of B-LBL presenting as facial swelling in a pediatric patient.
• To emphasize the diagnostic challenges and importance of prompt biopsy in suspected cases.
• To highlight the efficacy of standard pediatric lymphoma treatment protocols.

Main Methods:

• A case report of a 12-year-old girl with B-LBL.
• Diagnostic procedures included physical examination, ultrasound, skin biopsy, and PET/CT staging.
• Treatment followed an intermediate-risk pediatric lymphoma protocol.

Main Results:

• The patient presented with painless facial swelling, initially misdiagnosed as inflammatory.
• Skin biopsy confirmed B-LBL with characteristic immunophenotype (CD79a+, PAX5+, TdT+, high Ki67).
• Staging revealed extensive disease (Stage III), but induction chemotherapy led to complete resolution of facial swelling within 3 weeks.

Conclusions:

• B-LBL can present atypically in the head and neck, posing diagnostic challenges.
• Prompt skin biopsy is essential for accurate diagnosis of cutaneous B-LBL.
• Standardized pediatric lymphoma treatment protocols are effective in achieving remission.