Primary non-Hodgkin's lymphoma of the mediastinum: a clinicopathological report of six cases.
BACKGROUND
Primary mediastinal non-Hodgkin's lymphoma [NHL] predominates in young adult with diffuse large B-cell histologic characteristics, and favorable prognosis. Six patients with this disease were diagnosed and treated at the Tri-Service General hospital during the period of 1986 to 1991.


METHODS
Pathology data were reviewed. All cases were classified according to the International Working Formulation. All specimens were studied immunohistologic for immunoglobulin kappa and lambda light chains, common leukocyte antigen (CLA), B cell marker (L26) and T cell marker (MT1 & UCHL1). All patients were treated with cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) and adjuvant radiotherapy.


RESULTS
Most of the patients were young adults with bulky disease in the anterior mediastinum. All presented with symptoms attributed to a rapidly growing mass. Four patients had superior vena cava syndromes. The histologic types were B-cell type lymphoma, including immunoblastic cell in two, and diffuse large cleaved cells in four patients. Three were in stage II and the others were in stage IV. Complete response was achieved in four patients and partial response in two, with an overall response rate of 100%.


CONCLUSIONS
The results suggest that primary non-Hodgkin's non-lymphoblastic lymphoma commonly occurs in young adults and had an associated aggressive clinical course. In view of these results, observation have also suggested that intensive chemotherapy and bone marrow transplantation are needed for patients who relapse or fail to get complete remission.
Juan
M T
MT
Department of Internal Medicine, 804 Army General Hospital, Taipei, Taiwan, R.O.C.
Sheu
L F
LF
Chang
J Y
JY
Hwang
W S
WS
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000628:therapy; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone