Figure 1

Serial chest X-rays displaying the fulminant course of disease. Upon admission a mediastinal tumour was described (A). 23 hours after admission, the mediastinal tumour diminished, however, bilateral pulmonary infiltrates could be noted (B) which progressed rapidly (C, 6 hours later). D) bone marrow aspiration at diagnosis: 80% T-lymphatic blasts, E) histology of lung parenchyma: pulmonary capillaries obstructed by lymphatic blasts, no interstitial infiltrations of the lung parenchyma, pulmonary edema due to leukostasis (autopsy tissue), F) Histology of liver: liver cells with inflammatory signs (autopsy tissue).