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The present case report describes a rare case of T cell acute lymphoblastic lymphoma (T-LBL) in the lymph node with myeloid sarcoma in the pericardium. A 33-year-old Chinese male was admitted to hospital on 4 July 2015 exhibiting a fever and having experienced wheezing and fatigue for the previous 7 days. Routine pathological, computed tomographic, cytological and immunophenotypic observations revealed a diagnosis of T-LBL in the lymph node on 7 August 2015, without evidence of bone marrow (BM) involvement. The patient received induction chemotherapy for T-LBL and achieved partial remission. The patient was identified to have multiple serous effusion and analysis of pericardial effusion cells revealed the diagnosis of T-LBL with extramedullary myeloid sarcoma (without BM involvement) on 25 November 2015. On 30 December 2015, the patient was identified to exhibit proliferation of primary myeloid cells in the peripheral blood and BM, and an abnormal karyotype in BM cells, indicating that the complicated myeloid sarcoma involved the BM. No matched donor was available so the patient received chemotherapy to manage the disease. The patient was discharged on 31 January 2016 and ceased treatment. The patient succumbed on 19 February 2016 at home. To the best of our knowledge, T-LBL complicated with myeloid sarcoma had not been previously reported in Chinese adult male patients. In addition, the involvement of the BM and aberrant karyotype of the complicated myeloid sarcoma in the patient were rare.