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Spontaneous remission of T lymphoblastic lymphoma is rare but does occur.
The role of pomegranate juice in the induction of remission is not clear.
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.
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 …