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
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Affiliations:
- 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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Full Text
Abstract
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.
About the authors
Ya K Mangasarova
Hematology Research Center, Russian Academy of Medical Sciences
Email: v.k.jana@mail.ru
Hematology Research Center, Russian Academy of Medical Sciences
A U Magomedova
Hematology Research Center, Russian Academy of Medical Sciences
Email: maminat@mail.ru
Hematology Research Center, Russian Academy of Medical Sciences
S K Kravchenko
Hematology Research Center, Russian Academy of Medical Sciences
Email: krav@blood.ru
Hematology Research Center, Russian Academy of Medical Sciences
E E Zvonkov
Hematology Research Center, Russian Academy of Medical Sciences
Email: zvonkov@blood.ru
Hematology Research Center, Russian Academy of Medical Sciences
A M Kremenetskaya
Hematology Research Center, Russian Academy of Medical Sciences
Email: mtkalexandra@gmail.com
Hematology Research Center, Russian Academy of Medical Sciences
V I Vorobyev
Hematology Research Center, Russian Academy of Medical Sciences
Email: morela@mail.ru
Hematology Research Center, Russian Academy of Medical Sciences
D S Maryin
Hematology Research Center, Russian Academy of Medical Sciences
Email: dmdoc@mail.ru
Hematology Research Center, Russian Academy of Medical Sciences
A V Gubkin
Hematology Research Center, Russian Academy of Medical Sciences
Email: gubkin@blood.ru
Hematology Research Center, Russian Academy of Medical Sciences
N I Skidan
Hematology Research Center, Russian Academy of Medical Sciences
Email: nskidan@rabmler.ru
Hematology Research Center, Russian Academy of Medical Sciences
I B Kaplanskaya
Hematology Research Center, Russian Academy of Medical Sciences
Email: irinak@blood.ru
Hematology Research Center, Russian Academy of Medical Sciences
I A Vorobyev
Hematology Research Center, Russian Academy of Medical Sciences
Email: ivorobjev@mail.ru
Hematology Research Center, Russian Academy of Medical Sciences
R S Samoilova
Hematology Research Center, Russian Academy of Medical Sciences
Email: tb@blood.ru
Hematology Research Center, Russian Academy of Medical Sciences
A I Vorobyev
Hematology Research Center, Russian Academy of Medical Sciences
Email: director@blood.ru
Hematology Research Center, Russian Academy of Medical Sciences
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