[Convoluted-cell lymphoblastic lymphoma in children: a clinical case]

A case of convoluted cell lymphoblastic lymphoma in a 4 year old male is reported. Initially the patient presented with respiratory distress which led to the diagnosis of left pleural effusion. Neither several thoracenteses, nor the insertion of the chest tube were able to reduce the effusion, and in the meantime a pericardial effusion was observed. After two pericardiocenteses were unsuccessful, pericardiotomy was performed and an extensive invasion of pericardium, pleurae, mediastinum and diaphragm was demonstrated. The child died 48 hours later and the hystological diagnosis was of convoluted cell lymphoblastic lymphoma. The possibility of a neoplastic disease should be considered when such a contrast, between an insidious beginning with negative laboratory studies and the presence of an extremely severe clinical picture, not modified by treatment, is present. Early diagnosis and specific treatment are the only possibilities for survival.