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T-cell lymphoblastic lymphoma (T-LBL) and T-cell acute lymphoblastic leukemia (T-ALL) are malignant counterparts of thymocytes that share common pathogenic mechanisms. T-LBL patients mostly present with mediastinal and/or nodal masses, while T-ALL patients also present with excessive blast numbers in blood and/or bone marrow compartments. It remains unknown whether T-LBL and T-ALL reflect distinct diseases or different disease states from a common malignant progenitor. This study aims to increase our understanding of pathogenic mechanisms in sporadic and predisposed T-LBL patients.