T-cell Lymphoblastic Lymphoma Presenting as Bilateral Cervical Lymphadenopathy in a Young Adult: A Case Report

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.