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Distinguishing thymoma from T-lymphoblastic leukaemia/lymphoma: a case-based evaluation
  1. Prajwal Boddu1,
  2. Beenu Thakral2,
  3. Ahmed Alhuraiji3,
  4. Naveen Pemmaraju1,
  5. Tapan Kadia1,
  6. Maro Ohanian1,
  7. Farhad Ravandi1,
  8. Elias Jabbour1,
  9. William Wierda1,
  10. Joseph D Khoury2,
  11. Nitin Jain1
  1. 1 Department of Leukemia, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
  2. 2 Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  3. 3 Department of Hematology, Kuwait Cancer Center, Kuwait, Kuwait
  1. Correspondence to Nitin Jain, Department of Leukemia, MD Anderson Cancer Center, Houston, TX, USA; njain{at}; Joseph D Khoury, Department of Leukemia, MD Anderson Cancer Center, Houston, TX, USA; jkhoury{at}


T-lymphoblastic lymphoma and thymoma are distinct primary mediastinal neoplasms that can have similar clinical presentations and overlapping histological features. Microscopic distinction is occasionally difficult because the immature lymphocytes associated with thymoma may resemble T-lymphoblastic leukaemia/lymphoma cells, morphologically and immunohistochemically. An accurate diagnosis assumes particular importance since the treatment approaches for these two entities differ considerably. Multimodality diagnostic approaches incorporating histological, flow cytometry immunophenotypic‚ and molecular approaches are required. In this article, we describe four patients, each presenting with a mediastinal tumour in different clinicopathological settings. A detailed report of each case will follow, illustrating the challenges involved in the diagnosis in patients with these mediastinal neoplasms.

  • thymoma
  • T-cell
  • lymphoblastic lymphoma
  • flow cytometry
  • thymus

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  • Contributors PB, AA, NJ, JDK: involved in collecting data on the patients, writing the manuscript. BT: involved in providing images, writing and reviewing the manuscript. NP, TK, MO, FR, EJ, WW: involved in providing patients for the study, reviewing the manuscript.

  • Funding This study was supported in part by the MD Anderson Cancer Center Support Grant CA016672 and Award Number P01 CA049639.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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