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The neoplastic cells are defined by expression of T-lineage antigens (cytoplasmic or surface CD3) together with one or more markers of immaturity (terminal deoxynucleotidyl transferase, CD1a, CD34, CD99, or CD117) and must not fulfill criteria for early T-cell precursor acute lymphoblastic leukemia (ALL). This entity shows a marked male predominance (male:female \u2248 2:1) and predominantly affects children, adolescents, and young adults, accounting for approximately 15% of childhood ALL and 20%\u201325% of adult ALL cases. Pathologic diagnosis increasingly relies on recurrent molecular alterations such as activating NOTCH1 mutations (&gt;60% of cases), transcription factor rearrangements, and cell-cycle regulator inactivation. Although intensive multiagent chemotherapy regimens have substantially improved outcomes, particularly in pediatric patients, adults and high-risk molecular subgroups continue to experience inferior survival. This review provides a practical, pathology-oriented update on the epidemiology, pathogenesis, diagnostic criteria, differential diagnosis, prognostic factors, and current treatment approaches for T-ALL\/LBL.<\/jats:p>","DOI":"10.4132\/jptm.2026.08.01","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:09:16Z","timestamp":1789438156000},"page":"502-515","update-policy":"https:\/\/doi.org\/10.4132\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["T-lymphoblastic leukemia\/lymphoma: a comprehensive review of pathology, molecular features, and differential diagnosis"],"prefix":"10.4132","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5858-0541","authenticated-orcid":true,"given":"David","family":"Danielson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4310-6653","authenticated-orcid":true,"given":"Ian T.","family":"Lagerstrom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5794-5433","authenticated-orcid":true,"given":"Max","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0942-4480","authenticated-orcid":true,"given":"Kyle","family":"Simon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0014-6400","authenticated-orcid":true,"given":"Nadine S.","family":"Aguilera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5511-9912","authenticated-orcid":true,"given":"Aaron","family":"Auerbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2611","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001822"},{"key":"ref2","volume-title":"T-lymphoblastic leukaemia\/lymphoma. 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