Background: Sore throat is a common complaint encountered in daily clinical practice. It is a defining characteristic of acute tonsillitis which is typically treated with symptomatic care and antibiotics in cases of bacterial infection. Despite being generally uncomplicated, acute tonsillitis can mask sinister pathologies such as diphtheria, infectious mononucleosis, and even malignancy.
Case Report: In this report, we present a case of a young adult with nonresolving acute exudative tonsillitis. Upon recognition of unusual alarming features, further investigations have led to the diagnosis of T-cell acute lymphoblastic leukemia (T-ALL).
Conclusion: Although unusual, hematological malignancies such as acute leukemia may manifest as acute tonsillitis. The significance of recognizing red flags that may occur in com-mon symptoms such as sore throat is emphasized. It is necessary to be aware of this entity to prevent delayed diagnosis.