PRIMARY MEDIASTINAL B LARGE CELL LYMPHOMA - CASE REPORT

Abstract

Primary mediastinal large B cell lymphoma (PMLBCL) has been recognized as a specific subtype of diffuse large B cell lymphoma with characteristic clinical, pathological and biological features. This paper presents a diagnostic and therapeutic approach in the treatment of patient with this disease. A patient aged 35 years visited a doctor because of the presence of B-symptoms and signs of the existence of superior vena cava syndrome. After the transbronchial biopsy of the tumor mass, the diagnosis PMLBCL was established. This case has been regarded as localized stage lymphoma with medium risk. The patient received induction therapy by R-MACOP-B protocol and achieved a clinical response of partial remission type. After that, radiotherapy of mediastinum was carried and salavage therapy was applied but no further reduction in tumor mass was observed. Treatment was continued by the application of autologous hematopoietic stem cell transplantation. Control PET/CT scan showed the absence of a viable tumor, thus it was concluded that clinical response of complete remission type was achieved. The optimal therapeutic approach in the treatment of patients with PMLBCL remains a matter of debate. The use of a therapeutic protocol MACOP-B in combination with mediastinum radiotherapy has been demonstrated to improve disease-free survival, while the importance of additional treatment with rituximab and the role of PET scan in the assessment of therapeutic response continue to be reviewed.

Keywords

• primary mediastinal large B cell lymphoma
• chemotherapy
• radiotherapy
• combined modality treatment
• response rate