Introduction

Acute lymphoblastic leukemia (ALL) is a cancer of lymphoid blood cells characterized by large numbers of immature lymphocytes. ALL progresses rapidly and is fatal if left untreated.⁽¹⁾ Precursor lymphoid neoplasms are categorized as B and T lymphoblastic leukemia/lymphoma.⁽²⁾ Leukemia and lymphoma are overlapping clinical presentations of the same disease (i.e, B-ALL/LBL); diagnosis and classification do not distinguish between these entities.   B-cell acute lymphoproliferative disease manifest as pure leukemia (B-ALL) in 80% cases, isolated extra medullary disease (B-LBL) in 10% and mixed B-ALL/B-LBL in 10% cases.⁽³⁾ B-ALL/B-LBL is rare in adults and cases with spill-over in inguinal lymph nodes has not been reported as per our knowledge.

1. Childhood Acute Lymphoblastic Leukemia Treatment. National Cancer Institute. 2017.
2. Hirzel AC,Cotrell A,   Gasparini R,   Sriganeshan Precursor B-Cell Acute Lymphoblastic Leukemia/Lymphoma with L3 Morphology, Philadelphia Chromosome, MYC Gene Translocation, and Coexpression of TdT and Surface Light Chains: A Case Report. Case reports in pathology 2013;2013:679892.
3. Geethakumari PR, Hoffmann MS, Pemmaraju N, Hu S., Jorgensen JL., O'Brien S, Daver, N. Extramedullary B lymphoblastic leukemia/lymphoma (B-ALL/B-LBL): a diagnostic challenge. Clinical lymphoma, myeloma & leukemia 2014;14(4):115-118.
4. Siddique MN,Popalzai M, Aoun N et al. Precursor B-cell acute lymphoblastic leukemia presenting as obstructive jaundice: a case report. Journal of Medical Case Reports 2011; 5:269.
5. Pulte D, Jansen L, Gondos A, Katalinic A, Barnes B, Ressing M, et al. Survival of Adults with Acute Lymphoblastic Leukemia in Germany and the United States. Plos one 2014; 9(1):e85554.
6. Tuscano JM, Wang SE, Wun T et al. Lymphoblastic lymphoma. Drugs and diseases. Medscape. 2015.
7. Baljevic, Muhamed; Jabbour, Elias; O'Brien, Susan; Kantarjian, Hagop M. Acute Lymphoblastic Leukemia. The MD Anderson Manual of Medical Oncology. 2017; 3^rd
8. Singhal N,  Tahlan A, Bansal C,  Handa U,  D’ Cruz S. Coexistence of leukemic infiltration and extramedullary hematopoeisis in a lymph node: A cytological diagnosis. Journal of cytology 2011; 28(3): 138–140.
9. Seiter K, Talavera F, Sacher RA, Besa EC. Acute Lymphoblastic Leukemia (ALL) Workup. Medscape;2018.

10. Charles G. Mullighan. Molecular genetics of B-precursor acute lymphoblastic leukemia. Journal of Clinical Investigation 2012;122(10): 3407–3415.
11. Coustan SE, Behm FG, Sanchez J et al. Immunological detection of minimal residual disease in children with acute lymphoblastic leukaemia. Lancet. 1998; 351:550–554.

12. Chiaretti S, Zini G, Bassan R. Diagnosis and Subclassification of Acute Lymphoblastic Leukemia. Mediterranean Journal Of Hematology And Infectious Diseases.2014; 6(1).

Swati Sharma

VPIMS
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