Spontaneous remission of T lymphoblastic lymphoma
- M M Ceesay1,2,
- B Vadher1,
- B Tinwell1,
- R Goderya1,
- E Sawicka1
- 1Princess Royal University Hospital, Farnborough Common, Orpington, Kent BR6 8ND, UK
- 2Department of Haematological Medicine, Kings College Hospital, Denmark Hill, London SE5 9RS, UK
- M Mansour Ceesay, Department of Haematological Medicine, Kings College Hospital, Denmark Hill, London SE5 9RS, UK; mansourceesay{at}doctors.org.uk
- Accepted 22 May 2008
Take-home messages
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Spontaneous remission of T lymphoblastic lymphoma is rare but does occur.
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The role of pomegranate juice in the induction of remission is not clear.
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Very close monitoring is required to ensure that when relapse does occur this can be dealt with promptly.
Precursor T lymphoblastic leukaemia/lymphoblastic lymphoma is a highly aggressive disease often presenting in young adults with male predominance.1 This report describes a case of T cell acute lymphoblastic lymphoma that went into an apparent spontaneous remission with no readily identifiable cause.
CASE REPORT
A 44-year-old previously fit and well Caucasian man presented with a 1-week history of shortness of breath and pleuritic chest pain. He had weight loss of 1.5 kg in the preceding 4 weeks with night sweats but no fever. There was no significant past medical history and he was not on any medication. He was a non-smoker and worked as a porter. Chest x ray (CXR) requested by his general practitioner showed a large mediastinal mass associated with right-sided pleural effusion (fig 1). This drained 1.5 l of clear, straw-coloured transudate, which contained a large number of lymphocytes and some mesothelial cells. Ultrasound-guided biopsy of the mediastinal mass showed cores of fibroadipose tissue diffusely infiltrated by relatively monomorphous, medium-sized lymphoid cells displaying rounded nuclei with inconspicuous nucleoli, scanty cytoplasm and abundant apoptosis and …
