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Case 92 - Discussion

Hematopathology Case

 

T-Cell Lymphoblastic Lymphoma (T-LBL)

  • The patient had involvement of tumor cells in the bone marrow and peripheral blood.

  • Flow cytometry: low density for CD45, CD1a, CD3, CD4, CD5, CD8, CD34, CD38, and CD56. TdT is also positive.

  • Cytogenetics: hypodiploid with multiple genetic abnormalities

  • Discussion: the tumor cells are medium sized with round nuclei, moderately delicate chromatin and inconspicuous nucleoli. The cytoplasm is scant. There are three differential diagnoses of this so called "blastoid" morphology: Burkitt lymphoma, lymphoblastic lymphoma, and blastoid mantle cell lymphoma (typically in old patients). In contrast to B-cell acute lymphoblastic leukemia/lymphoblastic lymphoma (B-ALL/LBL), the T-ALL/LBL often presents as solid mass lesion in mediastinum, lymph node or other extranodal regions.