T cell lymphoblastic lymphoma with uncommon CD20 expression

We report an interesting case of a T lymphoblastic lymphoma (T-LBL) with uncommon CD20 expression. Immunophenotype analysis showed TdT expression with positivity of CD3 and CD7 among other T-lineage markers. Other non-T markers such as CD79a or myeloid-associated antigens were negative. Molecular studies were performed evidencing clonal rearrangements for gamma and beta chain T cell receptor were clonal in the lymph node biopsy. Cytogenetic analysis showed deletions in CDKN2A and NOTCH2 genes. CD20 when present in T-LBL can lead to a false diagnosis of B-LBL. In this scenario, analysis of rearrangements of both immunoglobulin heavy chain B cell receptor and rearrangement of the T cell receptor can be very helpful.