T-cell Lymphoblastic Lymphoma Presenting as Bilateral Cervical Lymphadenopathy in a Young Adult: A Case Report
Oumaima Mansoum *
ENT and Head and Neck Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
Saloua Ouraini
ENT and Head and Neck Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
Mohamed Rouihi
ENT and Head and Neck Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
Fouad Benariba
ENT and Head and Neck Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
Noureddine Errami
ENT and Head and Neck Surgery Department, Military Hospital Mohammed V, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: T-cell lymphoblastic lymphoma (T-LBL) is an uncommon, aggressive malignancy of immature T lymphocytes, predominantly affecting children and young adults. It typically presents with a mediastinal mass, but atypical presentations may delay diagnosis. Advances in treatment adapted from acute lymphoblastic leukemia protocols have significantly improved outcomes.
Case Presentation: We report a 20-year-old woman presenting with bilateral cervical lymphadenopathy and systemic B symptoms, including night sweats, fatigue, anorexia, and unquantified weight loss, without fever. Laboratory evaluation revealed microcytic hypochromic anemia and 17% circulating blasts. Cervical ultrasound suggested inflammatory lymphadenopathy. Excisional biopsy with immunohistochemistry confirmed T-LBL. The patient was referred promptly to hematology for further management.
Discussion: This case underscores an unusual presentation of T-LBL without mediastinal involvement. Persistent bilateral lymphadenopathy with B symptoms should prompt consideration of T-LBL. Early histopathological diagnosis and a multidisciplinary approach are crucial to initiate timely therapy and optimize prognosis.
Conclusion: Awareness of atypical presentations of T-LBL in young adults is essential for early detection and improved clinical outcomes.
Keywords: T-cell lymphoblastic lymphoma, cervical lymphadenopathy, young adult, B symptoms, non-Hodgkin lymphoma