Retroperitoneal mass presentations of B-immunoblastic sarcoma.
A clinicopathologic analysis of nine patients with B-immunoblastic sarcoma (B-IBS) presenting as a bulky lymph node-based retroperitoneal mass is reported. The histologic and immunologic findings, similar to those reported in B-IBS presenting in various other nodal and extranodal sites, support the recognition of this aggressive large cell non-Hodgkin's lymphoma (NHL) as a distinct pathologic entity. The patients, with a mean age of 60.5 years, presented for evaluation of abdominal pain and a palpable abdominal mass. Four patients were Stage II or IIE, one Stage III, and four Stage IV; eight of nine had B symptoms. Chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone, bleomycin [CHOP-B] or cyclophosphamide, doxorubicin, vincristine, methotrexate with leucovorin rescue, cytarabine [ACOMLA]) yielded significant palliation in five patients (mean survival, 12.3 months); three untreated patients and one receiving radiation treatment (XRT) died within 1 month from diagnosis. There was a striking predilection for pleuropulmonary involvement in disseminating disease. The initial blood lymphocyte count correlated significantly with survival (correlation coefficient, 0.84). The one durable complete remission (CR) was obtained in a patient who received substantial surgical debulking before chemotherapy.
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001402:B-Lymphocytes; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis; D008223:Lymphoma / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012186:Retroperitoneal Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*
D007136:Immunoglobulins