T-Cell Rich B-Cell Lymphoma A diagnostic dilemma in paediatric oncology

T-cell rich B-cell lymphoma, most commonly seen in adults and rarely reported in children is a type of Diffuse Large B cell Lymphoma. (DLBCL). It has several clinical, histological and immunohistochemical similarities to commonly Nodular lymphocyte predominant Hodgkin’s lymphoma. We report an 8 year-old boy who presented with a swelling over the right inguinal region for two months. FNAC of the swelling was inconclusive. MRI abdomen revealed multiple masses in right iliac fossa. Immunohistochemistry of the biopsy mass was consistent with T cell rich B cell lymphoma. T cell rich B cell lymphoma has a very low incidence in pediatric population and still remains unrecognized in most of the cases. When compared to adults, children have a better prognosis and hence stronger emphasis on immunohistochemistry is essential. Careful attention should be paid to differentiate the different neoplasms as each have a distinct course of clinical history and different therapies.