{
  "abstract": "A married woman in her early 30s presented with 2 months of dry cough, progressive dyspnoea and weight loss. Imaging revealed massive right pleural and severe pericardial effusions with a large anterior mediastinal mass. Initial lymphocyte-predominant exudative effusion suggested tuberculous pleuritis, but cytology was inconclusive. Thoracoscopic pleural biopsy with immunohistochemistry showed TdT-positive and CD7-positive lymphoid cells, establishing a diagnosis of T-lymphoblastic lymphoma (T-LBL) involving the pleura, pericardium and mediastinum. She received acute lymphoblastic leukaemia–type multi-agent chemotherapy and remains well, with no recurrence of effusion on follow-up. This case highlights the diagnostic challenge of distinguishing rare lymphomas from common infections in tuberculosis-endemic regions and underscores the necessity of early tissue diagnosis with immunophenotyping when faced with unexplained large pleuro-pericardial effusions. Prompt recognition is crucial because T-LBL requires intensive ALL-type therapy, which significantly improves survival compared with conventional lymphoma regimens.",
  "authors": [
    {
      "affiliations": [
        "Respiratory Medicine, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India"
      ],
      "name": "Supriya Adiody"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India"
      ],
      "name": "Vishnu Narayanan"
    },
    {
      "affiliations": [
        "Pulmonary and Sleep Medicine, MOSC Medical Mission Hospital, Thrissur, Kerala, India"
      ],
      "name": "Akhil Paul"
    },
    {
      "affiliations": [
        "Cardiology, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India"
      ],
      "name": "Manoj Ravi"
    },
    {
      "affiliations": [
        "Pathology, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India"
      ],
      "name": "Deepthy Vijayaraghavan"
    },
    {
      "affiliations": [
        "Pathology, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India"
      ],
      "name": "Rohini Sebastian"
    }
  ],
  "title": "T-lymphoblastic lymphoma presenting as massive pleuro-pericardial effusions: a rare diagnostic challenge in TB endemic regions",
  "uid": "8dd4ce5c-e61d-5cd9-a5c1-fb93ed90e33a"
}