Abstract
T-cell rich B-cell lymphoma, most commonly seen in adults and rarely reported in children is a type of Diffuse Large B cell Lymphoma. (DLBCL). It has several clinical, histological and immunohistochemical similarities to commonly Nodular lymphocyte predominant Hodgkin’s lymphoma. We report an 8 year-old boy who presented with a swelling over the right inguinal region for two months. FNAC of the swelling was inconclusive. MRI abdomen revealed multiple masses in right iliac fossa. Immunohistochemistry of the biopsy mass was consistent with T cell rich B cell lymphoma. T cell rich B cell lymphoma has a very low incidence in pediatric population and still remains unrecognized in most of the cases. When compared to adults, children have a better prognosis and hence stronger emphasis on immunohistochemistry is essential. Careful attention should be paid to differentiate the different neoplasms as each have a distinct course of clinical history and different therapies.
Highlights
T-cell rich B-cell lymphoma (TRBCL) is considered a rare variant of aggressive B-cell lymphoma described by few neoplastic B-cells in a background of numerous benign T lymphocytes and histiocytes[1]
Often misdiagnosed as classical Hodgkin lymphoma or nodular lymphocyte predominant Hodgkin lymphoma or reactive lymphadenopathies, this entity should be recognized in pediatric age group, as a less aggressive treatment results in relapses
We report a case of an 8 year old boy presenting with an inguinal swelling and abdominal mass which was initially thought to be Nodular lymphocyte predominant Hodgkins lymphoma and later confirmed by IHC as T cell rich B cell lymphoma, treated as per LMB 96 protocol and is in remission for 4 years
Summary
T-cell rich B-cell lymphoma (TRBCL) is considered a rare variant of aggressive B-cell lymphoma described by few neoplastic B-cells in a background of numerous benign T lymphocytes and histiocytes[1]. We report a case of an 8 year old boy presenting with an inguinal swelling and abdominal mass which was initially thought to be Nodular lymphocyte predominant Hodgkins lymphoma and later confirmed by IHC as T cell rich B cell lymphoma, treated as per LMB 96 protocol and is in remission for 4 years. Pediatric Review: International Journal of Pediatric Research Aailable online at: www.pediatricreview.in 584|P a g e mass could be felt over the right inguinal region It was non tender, not fixed to skin, and firm in consistency. The patient was started on chemotherapy as per LMB 96 (Group B) protocol and PET CT after 4 cycles of chemotherapy showed complete resolution He completed6cycles andis diseasefree for 4 years
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