Muhammad Tahir, Liaqat Ali.
Lymphoblastic Lymphoma in Children.
J Rawal Med Coll Jan ;4(1-2):27-9.

Introduction: Immunological characterization of lymphoblastic lymphoma has shown that 90% of the lymphoblastic lymphomas are of T-cell lineage, the remainder show B-cell precursor differentiation or non-B non-T cell differentiation. In lymphoblastic lymphoma, more than half of patients present with a short history of malaise and cough, progressing to dyspnoea due to presence of a mediastinal mass. The mediastinal mass is usually accompanied by pleural effusion. Bone marrow and CNS involvement are common. Lymphoblastic lymphoma is more common in males, having M:F ratio of 2:1. The median age for presentation varies from 7-9 yrs. Histologically, lymphoblastic lymphomas manifest convoluted, non convoluted or large cell. These cells show nuclei that are significantly smaller than reactive histiocytes and immunoblasts or large cleaved or non-cleaved follicular centre cells but are larger than small lymphocytes. The nuclei are round to oval in shape and have a small thin rim of cytoplasm . Typically, the tumour has a diffuse monotonous pattern, but may some times demonstrate selective involvement of the para-cortical (T-cell) areas of the lymph nodes. Study: A retrospective clinicomorphological study of thirty four consecutive cases of Lymphoblastic Lymphoma (LBL) in children is presented. The histological diagnosis was made on sections stained by H & E stains, and wherever necessary it was supported by stains for reticulin, PAS and MGP. The highest prevalence age group was 5-10 years, with a male: female ratio of 2.7:1. Sixty percent of cases presented with mediastinal lymph node enlargement. On histological examination, the tissue architecture was effaced in 85.3%. The neoplastic cells were medium sized with round to oval nuclei showing fine, delicate chromatin. The cytoplasm was scanty and weakly basophilic. Our findings were in agreement with previous studies.

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