An aberrant presentation of non-hodgkin’s lymphoma as pus: A curious journey

Abstract

T-lymphoblastic lymphoma (T-LBL) is most commonly found in younger age group and rare. It is most aggressive form ofnon-Hodgkin’s lymphoma. T-lymphoblastic lymphoma (T-LBL) response rate to chemotherapy is very good although relapse is common with poor survival rates.A 25 years old female presented to emergency department of a tertiary care centre with dyspnoea and chest tube in left Hemothorax in situ. She had earlier history of pulmonary tuberculosis 3 years back and took anti tubercular treatment for 6 months. On general examination we found left supraclavicular lymphadenopathy of size 2 × 1.5cm and grade 2 clubbing.The pleural fluid was sent for analysis. It was reported as exudative pleural effusion with low ADA and negative for malignant cells. Lymph node biopsy was sent for histopathological examination which was reported as T Lymphoblastic lymphoma. NHL is a diverse category of cancers that originate from B or T cells at different stages of maturation. In relation to our case; earlier history of tuberculosis, pus from lymph node could mislead to infective aetiology; as lymph node necrosis is commonly found in Hodgkin’s disease. This fact reiterates the fact that through clinical examination and history leads to proper diagnosis and management of the patient and can save time of the patients.