Primary mediastinal large B-cell lymphoma: Difference between revisions
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{{CMG}}; {{AE}} {{AS}} | {{CMG}}; {{AE}} {{AS}} | ||
{{SK}}: | {{SK}}: Mediastinal B-cell lymphoma; Mediastinal large B-cell lymphoma. | ||
== Overview == | == Overview == | ||
Revision as of 16:49, 7 March 2016
For patient information, click Insert page name here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]
Synonyms and keywords:: Mediastinal B-cell lymphoma; Mediastinal large B-cell lymphoma.
Overview
Pathophysiology
Associated Conditions
Microscopic Pathology
On microscopic histopathological analysis, are characteristic findings of primary mediastinal large B-cell lymphoma.
Causes
There are no established causes for primary mediastinal large B-cell lymphoma.
Differentiating type page name here from other Diseases
Primary mediastinal large B-cell lymphoma must be differentiated from other diseases such as:
Epidemiology and Demographics
Age
The incidence of primary mediastinal large B-cell lymphoma increases with age; the median age at diagnosis is 35 years.[1]
Gender
Females are more commonly affected with primary mediastinal large B-cell lymphoma than males.[1]
Risk Factors
There are no established risk factors for primary mediastinal large B-cell lymphoma.
Screening
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for primary mediastinal large B-cell lymphoma.
Natural History, Complications and Prognosis
- Primary mediastinal large B-cell lymphoma is usually a fast-growing (aggressive) lymphoma.
- Often have localized disease in the chest at first.
- Can cause shortness of breath, cough or chest pain as the tumour or mass grows in the chest.
- Can also partially block the main vein (superior vena cava) that carries blood from the upper body to the heart and cause superior vena cava syndrome.
- The bone marrow is rarely affected by this type of lymphoma.
- Recurrences or relapses often occur in organs or tissues outside the lymph nodes (extranodal sites), such as the kidneys or central nervous system.
Diagnosis
Staging
Staging for primary mediastinal large B-cell lymphoma is provided in the following table:[2]
| Stage | Involvement | Extranodal (E) status |
|---|---|---|
| Limited | ||
| Stage I | One node or a group of adjacent nodes | Single extranodal lesions without nodal involvement |
| Stage II | Two or more nodal groups on the same side of the diaphragm | Stage I or II by nodal extent with limited contiguous extranodal involvement |
| Stage II bulky | II as above with "bulky" disease | Not applicable |
| Advanced | ||
| Stage III | Nodes on both sides of the diaphragm; nodes above the diaphragm with spleen involvement | Not applicable |
| Stage IV | Additional noncontiguous extralymphatic involvement | Not applicable |
Symptoms
Symptoms of the primary mediastinal large B-cell lymphoma include:[1]
- Fever
- Weight loss
- Night sweats
- Skin rash
- Shortness of breath
- Painless swelling in the neck, axilla, groin, thorax, and abdomen
Physical Examination[1]
Vitals
- Fever is often present
HEENT
Thorax
- Thoracic masses suggestive of central lymphadenopathy
- Localized anterosuperior mediastinal mass
Abdomen
- Abdominal masses suggestive of central lymphadenopathy
Extremities
Laboratory Findings
Laboratory tests for primary mediastinal large B-cell lymphoma include:[1]
- Complete blood count (CBC)
- Blood chemistry studies
- Cytogenetic analysis
- Flow cytometry
- Immunohistochemistry
- Immunophenotyping:
Biopsy
Lymph node or bone marrow biopsy is diagnostic of .
CT
CT scan may be helpful in the diagnosis of primary mediastinal large B-cell lymphoma.
MRI
MRI scan may be helpful in the diagnosis of primary mediastinal large B-cell lymphoma.
Other Imaging Findings
PET scan may be helpful in the diagnosis of primary mediastinal large B-cell lymphoma.
Treatment
Medical Therapy
| Therapy | Description |
|---|---|
| Chemotherapy |
|
| Biological therapy |
|
| Radiation therapy |
|
| Stem cell transplant |
|
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Primary mediastinal large B-cell lymphoma. Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/seertools/hemelymph/51f6cf56e3e27c3994bd5318/. Accessed on March 7, 2016
- ↑ Cheson, Bruce D.; Fisher, Richard I.; Barrington, Sally F.; Cavalli, Franco; Schwartz, Lawrence H.; Zucca, Emanuele; Lister, T. Andrew; Alliance, Australasian Leukaemia and Lymphoma Group; Eastern Cooperative Oncology Group; European Mantle Cell Lymphoma Consortium; Italian Lymphoma Foundation; European Organisation for Research; Treatment of Cancer/Dutch Hemato-Oncology Group; Grupo Español de Médula Ósea; German High-Grade Lymphoma Study Group; German Hodgkin's Study Group; Japanese Lymphorra Study Group; Lymphoma Study Association; NCIC Clinical Trials Group; Nordic Lymphoma Study Group; Southwest Oncology Group; United Kingdom National Cancer Research Institute (2014-09-20). "Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification". Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 32 (27): 3059–3068. doi:10.1200/JCO.2013.54.8800. ISSN 1527-7755. PMID 25113753.
- ↑ Primary mediastinal large B-cell lymphoma. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/non-hodgkin-lymphoma/non-hodgkin-lymphoma/types-of-nhl/primary-mediastinal-large-b-cell-lymphoma/?region=nb. Accessed on March 7, 2016