Haematology: T-lymphoblastic lymphoma: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pathology · Haematology: T-lymphoblastic lymphoma

Sample item

A 16-year-old boy has cough, facial swelling and a large anterior mediastinal mass. Biopsy shows small to medium blasts with scant cytoplasm that express TdT and cytoplasmic CD3 but are negative for CD20 and CD30. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. T-lymphoblastic lymphoma

T-lymphoblastic lymphoma presents in adolescents with a bulky mediastinal mass and is biologically close to T-cell acute lymphoblastic leukaemia. The blasts express TdT and T-lineage markers.

Option by option

  • A. Thymoma

    Thymoma consists of epithelial cells with admixed immature T cells and occurs in older adults.

  • B. Primary mediastinal large B-cell lymphoma

    Primary mediastinal large B-cell lymphoma comprises large CD20 positive cells and not TdT positive blasts.

  • C. T-lymphoblastic lymphoma (correct)

    Correct. TdT positive blasts with T-lineage markers in a mediastinal mass indicate T-lymphoblastic lymphoma.

  • D. Nodular sclerosis Hodgkin lymphoma

    Nodular sclerosis Hodgkin lymphoma shows CD30 positive Reed-Sternberg cells and is TdT-negative.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, T-lymphoblastic lymphoma. T-lymphoblastic lymphoma presents in adolescents with a bulky mediastinal mass and is biologically close to T-cell acute lymphoblastic leukaemia.

Why is "Thymoma" not the answer?

Thymoma consists of epithelial cells with admixed immature T cells and occurs in older adults.

Why is "Primary mediastinal large B-cell lymphoma" not the answer?

Primary mediastinal large B-cell lymphoma comprises large CD20 positive cells and not TdT positive blasts.

Why is "Nodular sclerosis Hodgkin lymphoma" not the answer?

Nodular sclerosis Hodgkin lymphoma shows CD30 positive Reed-Sternberg cells and is TdT-negative.

What concept does this question test?

It tests Haematology: T-lymphoblastic lymphoma in Pathology. The blasts express TdT and T-lineage markers.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: T-lymphoblastic lymphoma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.