Research report: A case report: an 11-year-old boy with peripheral T-cell lymphoma presenting after a five-year indolent inguinal lymphadenopathy

An 11-year-old Ethiopian boy was diagnosed with peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), after a solitary, painless right inguinal swelling remained clinically stable for five years and then enlarged rapidly over three months. The case report found advanced-stage disease involving lymph nodes in the neck, abdomen and pelvis, as well as multiple bilateral pulmonary nodules, while bone marrow and cerebrospinal fluid were uninvolved. PTCL-NOS is a mature post-thymic T-cell neoplasm diagnosed only after more specific T-cell lymphoma entities have been excluded.

The disease is rare in children, represents a small minority of pediatric non-Hodgkin lymphomas and has no established standard of care. It is generally characterized as clinically aggressive, often presenting with advanced-stage disease over weeks to months. The boy’s case differed in its initial course because the inguinal swelling was painless and clinically stable for five years before rapid enlargement became apparent.

The boy had no fever, night sweats or other B symptoms. He also had no known immunodeficiency or reported contact with someone who had tuberculosis. Staging identified bilateral cervical adenopathy, extensive confluent abdominopelvic nodal masses, a necrotic right inguinal node and multiple nodules in both lungs, resulting in an Ann Arbor stage IV classification.

His lactate dehydrogenase concentration was persistently normal. Pathologists examined the lesion with a 16-marker immunohistochemical panel and found intermediate-sized cells expressing CD3 and CD5, along with mutant-type p53 expression. Only scattered residual CD20- and PAX-5-positive B-cell aggregates were present, and no follicular dendritic-cell meshwork was identified.

The remaining marker results were negative for CD30, CD15, CD23, BCL-6, CD10, CD1a, CD8, CD99 and TdT, and the Ki-67 index was 30–35%. These findings, considered with the clinical and imaging results, established the diagnosis of PTCL-NOS. The child was treated with an anaplastic large-cell lymphoma chemotherapy regimen through the B3 course and showed improvement. As a single case report without a comparison group, however, the study cannot determine whether that regimen is effective for pediatric PTCL-NOS more broadly or explain the prolonged stability of the initial swelling.

Its contribution is therefore limited to documenting an unusual pediatric presentation in which a five-year history of indolent inguinal lymphadenopathy preceded rapid enlargement and disseminated disease.

Subject of Research: Pediatric peripheral T-cell lymphoma presenting after prolonged inguinal lymphadenopathy

Article Title: A case report: an 11-year-old boy with peripheral T-cell lymphoma presenting after a five-year indolent inguinal lymphadenopathy

Article References: Amare, T. Z., Delelegn, T. M., & Abera, B. (2026). A case report: an 11-year-old boy with peripheral T-cell lymphoma presenting after a five-year indolent inguinal lymphadenopathy. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07829-9

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07829-9

Keywords: pediatric oncology, peripheral T-cell lymphoma, PTCL-NOS, inguinal lymphadenopathy, childhood lymphoma, immunohistochemistry, advanced-stage disease, case report, case, report, year-old, peripheral