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Case Reports
. 2024 Aug 2;16(8):e65994.
doi: 10.7759/cureus.65994. eCollection 2024 Aug.

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

Malabika Shil  1   2 , Vaishnavi Srinivasan  3 , Anjali A Vincent  4 , Trupti Gaikwad  5 , Delphia Thomas  6   2
Affiliations
Case Reports

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

Malabika Shil et al. Cureus. .

Abstract

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.

Keywords: lymphoblast; non-hodgkin’s lymphoma; oral lymphoma; t cell; t-cell lymphoma.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Frontal view of the patient showing severe diffuse swelling on the right middle third of the face.
Figure 2
Figure 2. Intraoral view of the swelling seen on the hard palate.
Figure 3
Figure 3. Panoramic image showing haziness and loss of floor in the right maxillary sinus.
Figure 4
Figure 4. (a) Cone-beam computed tomography reconstructed image showing bone destruction in the right maxillary region. (b) Axial view showing an ill-defined, hypodense osteolytic lesion with irregular borders and periphery.
Figure 5
Figure 5. CT images showing (a) coronal section with an ill-defined hypodensity noted in the right maxillary region and invasion into the maxillary sinus. (b) Axial section with hypodensity in the right maxilla.
Figure 6
Figure 6. Creamish white soft tissue bits altogether measuring about 7 cm × 1.5 cm.
Figure 7
Figure 7. Histopathological and immunohistochemical examination. (a) Hematoxylin and eosin stain (40×) showing highly cellular stroma and sheets of small-to-intermediate-sized lymphoid cells. (b) Lymphoblast showing positivity for CD99. (c) No staining of cells by CD45 marker. (d) Positive staining of lymphoblast by TdT marker.
Figure 8
Figure 8. Follow-up after six months. (a) Frontal view of the patient showing regression in size of the lesion. (b) Axial view of the patient showing regression of the lesion.
See this image and copyright information in PMC

References

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