Mohammed Said Rashid Al-Rashdi

Oman Medical Specialty Board
Oman

Abstract Title:T-Cell Lymphoblastic Lymphoma Presenting as Massive Pleural Effusion in a Pediatric Patient

Biography: Dr. Mohammed Said Rashid Al-Rashdi is a dedicated pediatric resident at Sultan Qaboos University Hospital, Oman, with a Bachelor of Science in Medicine from Sultan Qaboos University. He has completed a comprehensive clinical internship across multiple specialties, including pediatrics, medicine, and surgery, gaining experience at leading healthcare institutions in Oman. Dr. Al-Rashdi research interests include pharmacology, neurosurgery, and pediatric nephrology, with several publications in reputable medical journals such as the Oman Medical Journal and World Neurosurgery. He has presented at various national medical conferences and actively engages in continuing medical education. In addition to his clinical expertise, Dr. Al-Rashdi has demonstrated a commitment to community service through involvement in health awareness campaigns and blood donation drives. His professional focus lies in advancing pediatric care, clinical research, and contributing to the medical community in Oman

Research Interest: Introduction: T-cell lymphoblastic lymphoma (T-LBL) is a rare and aggressive pediatric malignancy, commonly presenting as an anterior mediastinal mass. Initial presentation as massive pleural effusion, however, is exceptionally uncommon. This case underscores the need for high clinical suspicion in atypical respiratory presentations to ensure timely diagnosis and intervention. Case Report: A previously healthy seven-year-old boy presented with acute chest pain, lethargy, and shortness of breath, initially managed for suspected bacterial pneumonia. Chest X-ray and ultrasonography revealed a massive right-sided pleural effusion. Despite initial management with antibiotics and chest drainage, cytological examination of the pleural fluid revealed numerous atypical lymphoblast. Immunophenotyping confirmed T lymphoblast, consistent with T-LBL. A subsequent CT scan identified lymphomatous infiltration in the thymus and hilar lymph nodes, with bone marrow analysis showing no blast cells. The patient commenced chemotherapy per the COG AALL 1231 protocol, achieving symptomatic relief and pleural effusion resolution. Discussion: This case highlights an unusual extramedullary presentation of T-LBL, emphasizing the importance of considering malignancy in pediatric patients with pleural effusions unresponsive to conventional therapy. Multimodal diagnostic approaches, including imaging, cytological analysis, and immunophenotyping, are essential for accurate diagnosis and prompt treatment initiation. Conclusion: Massive pleural effusion as the initial manifestation of T-LBL poses diagnostic challenges. This case underscores the need for a comprehensive diagnostic approach in pediatric patients with unexplained respiratory symptoms, improving prognosis through early recognition and treatment of this aggressive malignancy.