case_images: PMC8492265_01
case_images: Results of chest CT or PET-CT scan.
case_images: CRIHEM2021-5561860.001.jpg
case_images: PMC8492265_01_CRIHEM2021-5561860.001.jpg
case_images: fig1
case_images: A computed tomography (CT) scan revealed pericardial and right pleural effusion and lymphadenopathy at the cervical area bilaterally and within the mediastinum (Figure 1(a)). On day 15 and day 33 (TP1 or TP2) during the course of the induction of remission I, the BM smear showed 29.5% and 80% blast cells, FCM had 29% and 55.4% ETP lymphoblasts (Figures 4(a) and 4(b)), and a chest CT scan revealed an unchanged mediastinum mass (Figure 1(b)). HyperCVAD protocol were administered. After the 1st course, lymphoblasts were no longer detected in the BM during the evaluation of the BM smear (Figure 4(c)); the CT scan showed a partial remission (PR), which was subsequently monitored by CT scans (Figure 1(c)). He achieved CR after the 2nd course A, which was monitored by using BM smears (Figure 4(d)) and PET-CT scans (Figure 1(d)).
case_images: Results of mediastinum mass sample.
case_images: CRIHEM2021-5561860.002.jpg
case_images: PMC8492265_01_CRIHEM2021-5561860.002.jpg
case_images: fig2
case_images: A core needle biopsy and subsequent immunohistochemical (IHC) staining of the mediastinum mass was performed for CD3+, CD20-, PAX5-, CD7+, CD34-, Ki-67+(90%), MPO-, and CD99+(Figure 2). The results showed CD45pro-,CD5-, and CD79a were weak+, CD21 was positive, MUM-1 was negative, CD10 was positive, CK was negative, BCL6 was negative, c-MYC was (40%+), CyclinD1 was negative, ALK was negative, CD30 was negative, and P53 was negative (Figure 2).
case_images: Results of pleural effusion sample.
case_images: CRIHEM2021-5561860.003.jpg
case_images: PMC8492265_01_CRIHEM2021-5561860.003.jpg
case_images: fig3
case_images: Positive results for CD7, CD13, and cCD3 and negative results for CD1a, CD4, CD8, CD19, CD20, CD22, CD34, and MPO were confirmed (Figure 3). A chromosome karyotype of the pleural effusion sample was obtained using the International System of Human Cytogenetic Nomenclature 2009 (ISCN-2009): 43-50, X, Y, add(7) (p13), 9,?i(9) (q10), 14, 16, +22,?del(22) (q13), inc[CP8] (Figure 3).
case_images: Results of bone marrow samples.
case_images: CRIHEM2021-5561860.004.jpg
case_images: PMC8492265_01_CRIHEM2021-5561860.004.jpg
case_images: fig4
case_images: On day 15 and day 33 (TP1 or TP2) during the course of the induction of remission I, the BM smear showed 29.5% and 80% blast cells, FCM had 29% and 55.4% ETP lymphoblasts (Figures 4(a) and 4(b)), and a chest CT scan revealed an unchanged mediastinum mass (Figure 1(b)). HyperCVAD protocol were administered. After the 1st course, lymphoblasts were no longer detected in the BM during the evaluation of the BM smear (Figure 4(c)); the CT scan showed a partial remission (PR), which was subsequently monitored by CT scans (Figure 1(c)). He achieved CR after the 2nd course A, which was monitored by using BM smears (Figure 4(d)) and PET-CT scans (Figure 1(d)).