• Typically presents with acute respiratory distress in teenager; systemic dissemination common
• Usually T cell

• Usually teens / young adults
• Also ages 60-79 years
• Males more common than females

• 47 year old man with lymphoblastic lymphoma expressing natural killer cell phenotype with involvement of the mediastinum and nasal cavity (Am J Surg Pathol 1997;21:242)

• 5 year survival is 50% with multiagent chemotherapy

• Solid, soft, nonencapsulated, often extensive necrosis

• Diffuse growth or pseudonodular pattern
• Lymphocytes have even chromatin, inconspicuous nucleoli, increased nuclear / cytoplasmic ratio, but with nuclear grooves, frequent mitotic figures, extension into adipose tissue, vascular invasion
• Residual Hassall’s corpuscles may be present

Diffuse infiltrate of blasts replaces lymph node structure

Blasts have ill defined pale cytoplasm, fine nuclear chromatin

• CD1, CD2, CD3, CD43, CD99, bcl2, TdT

• Keratin

• Lymphocyte rich thymomas: unusual in children

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