探讨T淋巴母细胞性淋巴瘤(T-LBL)的诊断学特征。

回顾性分析2019年1月12日泰安市中心医院血液科收治的1例T-LBL患者的临床资料，并复习相关文献。

患儿，男性，12岁，因"颈部淋巴结肿大1周"入院。患儿双侧颈部淋巴结可触及肿大；外周血中原始淋巴细胞比例占0.15，乳酸脱氢酶1 154 U/L，神经元特异性烯醇化酶114.80 μg/L，其余实验室检查指标皆正常；颈部、胸骨后淋巴结彩超及胸部磁共振成像：双侧颈部及锁骨区多发肿大淋巴结，前中纵隔占位性病变；淋巴结免疫组化：CD34(-)，末端脱氧核苷酸转移酶(TdT)(+)，CD10(+)，CD3(+)，CD5(+)，CD20(-)，B细胞特异性激活蛋白(BSAP)(-)，B细胞淋巴瘤-2(Bcl-2)(+)，原癌基因C-MYC阳性率70.0%，Ki-67阳性率>90.0%，确诊为T-LBL。

T-LBL是一类少见的高侵袭性淋巴瘤，依据病理学、细胞遗传学、影像学检查结合免疫组化BSAP、TdT、CD34、Ki-67检测的联合应用可对该病做出准确诊断。

To explore the diagnostic features of T-lymphoblastic lymphoma (T-LBL).

The clinical data of 1 case of T-LBL in Hematology Department of Taian City Central Hospital in January 12, 2019 was analyzed retrospectively, and relevant literatures were reviewed.

The child, a 12-year-old male, was admitted to the hospital for " neck lymph node enlargement for 1 week" . The child′s bilateral cervical lymph nodes were palpable and enlarged. 0.15 of primordial lymphocytes were detected in peripheral blood, lactate dehydrogenase 1 154 U/L, neuron-specific enolase 114.80 μg/L, the rest of the laboratory test results were normal. Color Doppler ultrasound of cervical and posterior sternal lymph nodes and magnetic resonance imaging showed that multiple enlarged lymph nodes in the bilateral neck and clavicle area, anterior mediastinal space occupying lesions. Lymph node immunohistochemistry showed that CD34(-), terminal deoxynucleotidyl transferase (TdT)(+ ), CD10(+ ), CD3(+ ), CD5(+ ), CD20(-), B-cell specific activating protein (BSAP) (-), B-cell lymphoma 2 (Bcl-2) (+ ), C-MYC positive rate of proto-oncogene was 70.0%, positive rate of Ki-67>90.0%, T-LBL was pathologically diagnosed.

T-LBL is a rare type of highly aggressive lymphoma. According to pathology, cytogenetics, imaging examination combined with immunohistochemistry markers BSAP, TDT, CD34 and Ki-67 can make accurate diagnosis of the disease.