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Spontaneous remission of T lymphoblastic lymphoma
  1. M M Ceesay1,2,
  2. B Vadher1,
  3. B Tinwell1,
  4. R Goderya1,
  5. E Sawicka1
  1. 1
    Princess Royal University Hospital, Farnborough Common, Orpington, Kent BR6 8ND, UK
  2. 2
    Department of Haematological Medicine, Kings College Hospital, Denmark Hill, London SE5 9RS, UK
  1. M Mansour Ceesay, Department of Haematological Medicine, Kings College Hospital, Denmark Hill, London SE5 9RS, UK; mansourceesay{at}doctors.org.uk

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Take-home messages

  • 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.

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 …

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