CTICasesT-cell Lymphoblastic Lymphoma
Imaging findings
Chest CT of a young woman demonstrates a large, highly heterogeneous, and aggressive anterior mediastinal mass with areas of low-attenuation necrosis. The mass exerts significant mass effect on adjacent mediastinal structures and the right lung, causing post-obstructive atelectasis and consolidative infection. Pleural effusion and pleural involvement are also noted.
Key takeaways
T-cell lymphoblastic lymphoma is an aggressive mediastinal neoplasm that typically presents in children and young adults (with a male predominance, though it can occur in young females). It is characterized by rapid growth, early pleural/pericardial involvement, and a high risk of airway or superior vena cava compression. On imaging, it tends to be more heterogeneous and necrotic than other lymphomas (such as Hodgkin lymphoma or diffuse large B-cell lymphoma) but responds rapidly and dramatically to chemotherapy, often returning the thymus to a normal size and appearance.
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