Early t-cell precursor acute lymphoblastic leukemia presenting as pericardial tamponade

Abstract

Background: Acute Lymphoblastic Leukemia (ALL) is a malignant disorder of lymphoid progenitor cells that commonly presents with symptoms related to bone marrow failure. However, extramedullary manifestations may occasionally be the initial presentation. Pericardial effusion leading to cardiac tamponade is a rare but life-threatening complication associated with hematological malignancies. We report the case of a 31-year-old female with no known comorbidities who presented with dry cough for two months and breathlessness for one week. Echocardiography revealed massive pericardial effusion with features of cardiac tamponade, for which emergency pericardiocentesis was performed. Further evaluation with flow cytometry confirmed Early T-cell Precursor Acute Lymphoblastic Leukemia (ETPALL). This case highlights the importance of considering hematological malignancy in patients presenting with unexplained pericardial effusion and mediastinal masses.