We report a 27-year-old man who presented with cardiac tamponade and was eventually diagnosed of T-cell lymphoblastic lymphoma (T-LBL) by the flow cytometric analysis of pericardial fluid. Despite pericardiocentesis and institution of standard chemotherapy, the patient developed malignant arrhythmia with hemodynamic instability, and died soon after admission. Cardiac tamponade is rarely the first manifestation of a T-LBL.
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