T-Lymphoblastic Leukemia/Lymphoma and Thymoma: A Case Report and Review of the Literature of a Rare Association

Acta Haematol. 2022;145(1):106-111. doi: 10.1159/000519033. Epub 2021 Sep 17.

Abstract

The co-occurrence of thymoma and T-lymphoblastic lymphoma/leukemia is an extremely rare but previously reported association that poses a diagnostic and therapeutic challenge. We describe a 67-year-old patient with long-standing untreated B1 thymoma that presented with constitutional symptoms and a painless soft tissue mass on the right chest wall. Pathological analysis of the biopsy from the mass demonstrated T-lymphoblastic leukemia/lymphoma. The patient went through a complicated course, was refractory to several lines of therapy, and eventually underwent allogeneic hematopoietic stem cell transplantation in complete remission from a matched related donor. The association between thymoma and malignant neoplasms has been described in the literature, most notably with colorectal adenocarcinoma and thyroid cancer. Thymoma-associated leukemia is, however, extremely unusual, with limited reports in the literature. Distinguishing between thymoma and leukemia can be challenging and often requires meticulous diagnostic efforts. For patients with a past history of thymoma, awareness of this particular association should be bared in mind to allow earlier diagnosis and therapy.

Keywords: Leukemia; T-lymphoblastic lymphoma/leukemia; Thymoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Allografts
  • Biopsy
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Neoplasms, Second Primary* / diagnosis
  • Neoplasms, Second Primary* / pathology
  • Neoplasms, Second Primary* / therapy
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma* / diagnosis
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma* / pathology
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma* / therapy
  • Thymoma* / diagnosis
  • Thymoma* / pathology
  • Thymoma* / therapy
  • Thymus Neoplasms* / diagnosis
  • Thymus Neoplasms* / pathology
  • Thymus Neoplasms* / therapy