A case of conjunctival precursor T cell lymphoblastic lymphoma presenting with salmon colored conjunctival mass

Abstract

Purpose: T-Lymphoblastic lymphoma (T-LBL) is a rare malignant tumor originated from precursor T-lymphocytes that differentiate to T lymphocytes. We report a rare case of T-LBL presenting with conjunctival mass as the first sign. Observations: A 61-year-old man presented with a right salmon colored conjunctival mass. A biopsy was performed, and histopathologic examination showed dense lymphocyte proliferation in subepithelial substantia propria. Immunohistochemical staining was positive for CD7, CD10, and TdT; and negative for CD20. CD3 was negative in most parts PET-CT revealed abnormal uptake in the left cervix, anterior mediastinum, abdominal aortic lymph nodes, and multiple bones. From the above findings, stage IVA T-LBL was diagnosed. The patient received hyper CVAD therapy (cyclophosphamide + doxorubicin + vincristine + dexamethasone) and HD-MA therapy (high-dose methotrexate + cytarabine). Subsequently, an unrelated bone marrow transplant was performed. Conclusions and importance: This case demonstrates the importance of considering rare lymphomas such as T-LBL in the differential diagnosis of ocular adnexal lymphoid neoplasms.

Keywords

• T-cell lymphoblastic lymphoma
• Conjunctival lymphoma
• Terminal deoxynucleotidyl transferase