title: Mediastinal mass and malignant pleural effusion in an aleukemic case with pre-B acute lymphoblastic leukemia.
abstract: Pleural effusions and mediastinal masses are associated with certain types of hematologic malignancies. We report a 20-year-old man with a pleural effusion, a mediastinal mass, and a normal hemogram. The cytology of the pleural effusion initially suggested a lymphoma. However, an immunophenotypic study of the effusion revealed the following: TdT+, CD34+, CD19+, CD7(-), CD33(-), CD10(-), sIgM(-), and positive cytoplasmic mu heavy-chain immunoglobulins. After a bone marrow examination, we diagnosed the patient with pre-B acute lymphoblastic leukemia (ALL). This is the first reported case of a malignant pleural effusion and a mediastinal mass that preceded pre-B ALL. After standard therapy for ALL, the patient has been disease-free for 7 years.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Sung-nan
authors.initials: SN
authors.lastname: Pei
authors.forename: Ching-yuan
authors.initials: CY
authors.lastname: Kuo
authors.forename: Ming-chun
authors.initials: MC
authors.lastname: Ma
authors.forename: Ming-chung
authors.initials: MC
authors.lastname: Wang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001856:Bone Marrow Examination; D018572:Disease-Free Survival; D006801:Humans; D016130:Immunophenotyping; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis*; D016066:Pleural Effusion, Malignant / Q000175:diagnosis*; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000628:therapy; D055815:Young Adult