To clarify the clinicopathological features including symptoms, chest CT scan and histopathological findings, and outcome of primary mediastinal lymphoma.
We performed a retrospective review of 29 patients with mediastinal lymphoma, who were diagnosed and treated at Toranomon Hospital during the period between October 1991 and December 2008.
The 29 patients consist of 6 men and 13 women, with the median age of 40 years. At the time of diagnosis, 80% of the patients presented with symptoms including superficial lymphadenopathy (31%), fever, cough and dyspnea (24%), respectively. Histological diagnosis was confirmed in all patients by percutaneous needle biopsy (38%), video-assisted thoracoscopic biopsy (35%), tumor resection (14%), or superficial lymph node biopsy (10%). Tumors were histologically classified as Hodgkin lymphoma (n = 11, 38%), diffuse large B-cell lymphoma (DLB; n = 7, 24%), extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT; n = 6, 21%), follicular lymphoma (n = 2, 7%), lymphoblastic lymphoma (LBL; n = 2, 7%), anaplastic large cell lymphoma (n = 1, 3%), respectively. Some of the CT features were associated with specific histologic subtypes. The presence of multiple nodular lesions or cystic mass in anterior mediastinum is characteristic of Hodgkin lymphoma or MALT lymphoma, respectively. DLB was predominantly associated with mediastinal soft tissue mass. Chemotherapy was given in 24 patients including 4 and 20 patients with or without subsequent bone marrow/hematopoietic stem cell transplantation, respectively, whereas no chemotherapy was given in four patients with MALT lymphoma after surgical resection. The outcome was favorable with long-term survival except for one with LBL.
Despite of various clinical features of PMML, the histological subtype of had characteristic CT findings. Regardless of the type of treatments, PMML had good prognosis.
Primary mediastinal lymphoma is relatively uncommon in routine practice. Primary mediastinal lymphoma tends to demonstrate excellent prognosis despite of the various clinical features and histological subtypes. Precise evaluation of CT scan is imperative in assessing mediastinal lymphoma.
Shiho Yamakoshi, No Financial Disclosure Information; No Product/Research Disclosure Information