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Vol.47 No.3 contents | Japanese/English |
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- Case Report -
A Case of T-Cell Acute Lymphoblastic Lymphoma Mimicking Thymoma
Masatsugu Ohuchi1, Shuhei Inoue1, Jun Hanaoka1, Tomoyuki Igarashi1, Shozo Fujino21Department of Thoracic Surgery, National Hospital Organization Shiga Hospital, Japan, 2Department of Thoracic Surgery, National University Corporation, Shiga University of Medical Science, Japan
Background. In the anterior mediastinum, tumors originated from various tissue may occur such as thymic, epithelial, germinal or lymphoproliferative disorders. It is sometimes difficult to differentiate lymphoblastic lymphoma from lymphocyte-rich thymoma. Case. An anterior mediastinal tumor was noted in a 65-year-old man by chest roentgenogram and he was admitted to our hospital. Chest CT revealed a mass protruding into the left pleural cavity from the anterior mediastinum. We suspected thymoma and performed total thymectomy. The tumor was found to be the lymphocyte-rich thymoma (WHO type B1), Masaoka's stage I by pathological examination. He was admitted to our hospital again 1 month later after surgery, because of pleural effusion, ascites, systemic lymphadenopathy and splenomegaly. The diagnosis of T-cell lymphoblastic lymphoma was made by left inguinal lymph node biopsy. Systemic chemotherapy was performed, but he died due to multiple organ failure. Conclusion. It is considered that lymphoma requiring immediate intensive chemotherapy is included in mediastinal tumors, so if lymphocyte-rich thymoma is suspected, further examination to differentiate lymphoma, as well as histologic diagnosis of the tumor, are necessary to confirm correct diagnosis promptly.
key words: Mediastinal tumor, Thymoma, Lymphoblastic lymphoma, Total thymectomy, Flowcytometry
Received: February 5, 2007
Accepted: May 1, 2007
JJLC 47 (3): 277-283, 2007
