Introduction: acute lymphoblastic or lymphoblastic leukemia is the most frequent neoplasm in pediatric ages. In childhood, most are B-cells, only 12% to 15% have T-immunophenotype. Acute lymphoblastic leukemia- T is a disease with remarkable clinical and biological heterogeneity that frequently occurs in young adults, usually males, with a high count of white blood cell, mediastinal mass and possible invasion of the central nervous system.
Case Report: a male adolescent with upper right edema, lateral neck region and hemiface of the same side associated with cough, in addition to left peripheral facial paralysis and hepatosplenomegaly. A mediastinal widening with left pleural effusion was evidenced in chest X-ray, the presence of a large tumor mass occupying the anterosuperior and middle part of the mediastinum with left predominance is observed by means of computer axial tomography of the chest. In the clinical laboratory tests, hyper-leukocytosis was observed with 49% of blasts and a marked uric acid as well as LDH increase; the medullogram showed the presence of 90% of lymphoid-like blasts, being confirmed by immunophenotyping approach with the aid of flow cytometry and T-cell lineage.
Conclusions: the nonspecific character of the initial clinical manifestations is highlighted, as indicators of different diagnoses, so it is considered useful and interesting to refer the case to the consideration of other health professionals
