Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes: diagnosis and treatment

Ya K Mangasarova; Мангасарова Яна Константиновна; A U Magomedova; Магомедова Аминат Умарасхабовна; S K Kravchenko; Кравченко Сергей Кириллович; E E Zvonkov; Звонков Евгений Евгеньевич; A M Kremenetskaya; Кременецкая Александра Михайловна; V I Vorobyev; Воробьев Владимир Иванович; D S Maryin; Марьин Дмитрий Сергеевич; A V Gubkin; Губкин Андрей Владимирович; N I Skidan; Скидан Наталья Ивановна; I B Kaplanskaya; Капланская Ирина Борисовна; I A Vorobyev; Воробьев Иван Андреевич; R S Samoilova; Самойлова Римма Семеновна; A I Vorobyev; Воробьев Андрей Иванович

Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes: diagnosis and treatment

Authors: Mangasarova Y.K¹, Magomedova AU¹, Kravchenko SK¹, Zvonkov EE¹, Kremenetskaya AM¹, Vorobyev VI¹, Maryin DS¹, Gubkin AV¹, Skidan NI¹, Kaplanskaya IB¹, Vorobyev IA¹, Samoilova RS¹, Vorobyev AI¹
Affiliations:
1. Hematology Research Center, Russian Academy of Medical Sciences
Issue: Vol 82, No 7 (2010)
Pages: 61-65
Section: Editorial
URL: https://ter-arkhiv.ru/0040-3660/article/view/30640
ID: 30640

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Abstract

Aim. To diagnose diffuse large B-cell lymphosarcoma (DLBCLS) with primary involvement of the mediastinal lymph nodes (LN) and to evaluate the efficiency of aggressive polychemotherapy (PCT).
Subjects and methods. The study included 15 patients (6 men and 9 women aged 18 to 70 years; median 38 years) followed up at the Hematology Research Center, Russian Academy of Medical Sciences, in 2004 to 2009. Three and 12 patients had Stages II and IIE DLBCLS, respectively. B symptoms were found in 14 (93.4%) patients. Increased lactate dehydrogenase (LDH) concentrations were detectable in 14 (93.4%) patients; tumors of 10 cm or more (bulky disease) were seen in 11 (73.3%). Enlarged cervical, supraclavicular, and axillary lymph nodes were found in 9 (60%) patients; lung involvement via extension in 9 (60%), and invasion into the pericardium in 5 (33.3%) and soft tissues of the anterior thoracic wall in (13.3%). There were no signs of involvement of extranodal organs at the moment of diagnosis. All the 15 patients received PCT according to the modified NHL-BFM-90 program: 4 to 6 courses depending on the response to the therapy; 10 (66.6%) and 5 (33.3%) patients had 4 and 6 courses, respectively; for consolidating purpose, 11 (78.5%) patients were prescribed radiotherapy applied to the mediastinum in a cumulative dose of 36 Gy due to the fact that they had a residual mass.
Results. Thirteen (86.6%) patients achieved a complete remission (CR). Primary PCT resistance was confirmed in one case. Another patient was stated to have near-complete remission. No recurrences were notified during the follow-up. The mean CR duration was 24.5 (range 2-49) months.
Conclusion. DLBCLS with primary LN involvement is an individual nosological entity to be differentiated from primary mediastinal large B-cell lymphosarcoma. In most cases, DLBCLS shows signs of a poor prognosis, which makes it necessary to perform aggressive PCT.

Keywords

mNHL-BFM-90, diffuse large B-cell lymphosarcoma, primary mediastinal lymphosarcoma, mNHL-BFM-90, radiotherapy

References

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Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes: diagnosis and treatment

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About the authors

References

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