T-cell Lymphoblastic Leukemia/Lymphoma (T-ALL)

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Primary Hematopoietic and Lymphoid Tissue ›› Thymus ›› Abnormal

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›Microscopic Features:

3-4x larger than a mature RBC
High nuclear to cytoplasmic ratio
Round Nucleus with immature chromatin (not clumped)
Prominent nucleoli
Cytoplasm is scant, light blue in color and lacks granules

›Normal % blood-PB, marrow-BM, lymphoid tissue-LN:

PB: None
BM: None
LN: None

›May Resemble:

›Differential Diagnoses:

If in blood, bone marrow or tissue:
T-Lymphoblastic leukemia/lymphoma (T-ALL)
B-Lymphoblastic leukemia/lymphoma (B-ALL)
AML

›Classic Immunophenotype:

CD3+ (cytoplasmic)
CD7+
TdT+
CD1a (variable)
CD2 (variable)
CD5 (variable)
CD4 (variable)
CD8 (variable)

›Cartoon Image:

T-cell Lymphoblastic Leukemia/Lymphoma (T-ALL) cartoon

Click and drag Red blood cell for scale

for direct comparison

›Misc:

Can arise from thymus (Anterior Mediastinum). Remember the mnemonic for Anterior Mediastinal lesions/masses: 4 Ts (Thymoma, Terrible Lymphoma such as T-lymphoblastic lymphoma, Thyroid neoplasms, and Teratoma or other germ cell neoplasms)