Bălănescu Radu Ninel, Bălănescu Laura, Cordoş Ioan, Sfrijan Doiniţa, Pop Florinel, CaragaŢă Florentina-Ruxandra, Mălăescu Gheorghe Dan
Department of Pediatric Surgery, "Grigore Alexandrescu" Clinical Emergency Hospital for Children, Bucharest, Romania;
Rom J Morphol Embryol. 2015;56(4):1541-3.
T-cell lymphoblastic lymphoma is an aggressive malignancy that represents 85% of all lymphoblastic lymphomas. It usually occurs in late childhood, adolescence and young adulthood with a 2:1 male preponderance and it presents with pleural effusion and respiratory symptoms and in rare cases vena cava syndrome can be encountered. We present the case of a 13-year-old patient who was referred to our clinic from a local hospital where he was diagnosed with a mediastinal tumor. The patient presented with thoracic pain, fever, coughing and fatigability for a month prior to admission, after having underwent surgery for abdominal pain (appendectomy). On admission to our hospital, a thoracic computed tomography (CT) scan was performed and showed the presence of an anterior mediastinal mass measuring 109/76/140 mm, well defined, which came in close contact with the superior vena cava, the ascending aorta and the pulmonary artery, right pleural effusion and a collapsed lung on the right side. The decision was taken to perform a tumor biopsy and a right pleural drain was placed. The patient's post-operative evolution was favorable with the remission of the respiratory symptoms. The histopathological result showed the presence of T-cell lymphoblastic lymphoma and the patient was then transferred to the oncology ward where he underwent chemotherapeutic treatment, with a favorable outcome. T-cell lymphoblastic lymphoma is an aggressive type of lymphoma and it is usually hard to diagnose considering the fact that the symptoms are often vague. It is essential to establish the diagnosis without delay and start appropriate chemotherapeutic treatment.
T 细胞淋巴母细胞淋巴瘤是一种侵袭性恶性肿瘤，占所有淋巴母细胞淋巴瘤的 85%。它通常发生在儿童晚期、青少年和青年期，男性发病率是女性的 2 倍，表现为胸腔积液和呼吸道症状，罕见情况下可出现腔静脉综合征。我们报告一例 13 岁患者，他从当地医院转诊至我们诊所，在当地医院被诊断为纵隔肿瘤。该患者在因腹痛接受手术（阑尾切除术）后，入院前一个月出现胸痛、发热、咳嗽和乏力症状。入院后，进行了胸部计算机断层扫描（CT），显示前纵隔有一个大小为 109/76/140 mm 的肿块，边界清晰，与上腔静脉、升主动脉和肺动脉密切接触，右侧胸腔积液，右侧肺萎陷。决定进行肿瘤活检并放置右侧胸腔引流管。患者术后恢复良好，呼吸道症状缓解。组织病理学结果显示为 T 细胞淋巴母细胞淋巴瘤，随后患者被转至肿瘤科病房接受化疗，治疗效果良好。T 细胞淋巴母细胞淋巴瘤是一种侵袭性淋巴瘤，鉴于症状往往不明确，通常很难诊断。必须毫不拖延地确立诊断并开始适当的化疗。
