title: Primary mediastinal large B-cell lymphoma: a comparative study with nodular sclerosis-type Hodgkin's disease.
abstract: The clinicopathological features of 10 patients with primary mediastinal large B-cell lymphoma (PMLBCL) are described. The patients were aged 19 to 63 years, with a median age of 25.5 years. There were 5 men and 5 women. All patients presented with chest symptoms, and 6 presented with superior vena cava syndrome. Nine patients had bulky mediastinal tumors. The disease was confined within the thorax and contiguous lymph nodes, although multiple liver tumors were observed in 1 patient. Laboratory findings included high lactate dehydrogenase levels and elevated C-reactive protein levels. The soluble interleukin 2-receptor level was high in 6 patients tested. A comparative study of PMLBCL and nodular sclerosis-type Hodgkin's disease (NS-HD) with a mediastinal mass revealed substantial overlap in clinical features. Histopathological examination of biopsy specimens of PMLBCL revealed clusters of CD20+ large cells; however, CD30+ Hodgkin/Reed-Sternberg-like cells were occasionally seen, raising the potential to misdiagnose PMLBCL as NS-HD. The patients with PMLBCL were treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone), biweekly CHOP, or MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisolone, and bleomycin) regimen, and 6 received consolidation radiotherapy to the involved field. With the exception of 1 patient who was primarily refractory to therapy, 9 patients (90%) achieved complete response and 7 (70%) remain in continuous remission with a mean follow-up of 24 months.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Kyoto University, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Yonetani
authors.forename: M
authors.initials: M
authors.lastname: Kurata
authors.forename: M
authors.initials: M
authors.lastname: Nishikori
authors.forename: H
authors.initials: H
authors.lastname: Haga
authors.forename: K
authors.initials: K
authors.lastname: Ohmori
authors.forename: H
authors.initials: H
authors.lastname: Yamabe
authors.forename: T
authors.initials: T
authors.lastname: Uchiyama
authors.forename: H
authors.initials: H
authors.lastname: Ohno
mesh_terms: D000328:Adult; D018951:Antigens, CD20 / Q000032:analysis; D000951:Antigens, Neoplasm / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D017730:Ki-1 Antigen / Q000032:analysis; D008198:Lymph Nodes / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000188:drug therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D012598:Sclerosis; D016896:Treatment Outcome
chemical_list: D018951:Antigens, CD20; D000951:Antigens, Neoplasm; D017730:Ki-1 Antigen