Cardiac tamponade as an initial atypical presentation of T-cell lymphoblastic lymphoma in a 17-year-old adolescent: a case report

Fig. 1. Electrocardiogram: sinus tachycardia at 110 beats per minute associated with electrical alternans (red arrows)

Fig. 2. Subcostal view Transthoracic Echocardiography (TTE) showing massive pericardial effusion (blue arrows)

Fig. 3. Axial view of computed tomography scan showing the voluminous mass (red arrow) occupying the anterior and middle mediastinum, with some cystic areas and irregular contours, including the large vessels

Fig. 4. Sagittal computed tomography view showing the mass (red arrow) occupying the anterior mediastinum and encompassing the large vessels (red arrow)

Fig. 5. Axial computed tomography view showing a medium-sized pericardial effusion after pericardiocentesis (red arrow)

Fig. 6. Striated and fibro-adipose muscle tissue infiltrated by a tumor proliferation of diffuse architecture, made of small- to medium-sized monomorphic cells; diffuse architect of small- to medium-sized monomorphic tumor cells with dense nuclei and scant cytoplasm (yellow arrow) and fibrous stroma (blue arrow)

Fig. 7. Diffuse and intense expression of cluster of differentiation 3 by tumor cells (blue arrows)

Fig. 8. Diffuse and moderate expression of Terminal desoxynulceotidyl transferase (Tdt) by tumor cells (blue arrows)

Fig. 9. Diffuse and low-to-moderate expression of cluster of differentiation 99 by tumor cells (blue arrows)

Fig. 10. Absence of cluster of differentiation 20 expression by the tumor cells (blue arrows)