Presentation
We report a case of primary mediastinal large B cell lymphoma in a 46-year-old woman of African descent who is human immunodeficiency virus positive who presented with symptoms of superior vena cava syndrome. [ncbi.nlm.nih.gov]
Case presentation We report a case of primary mediastinal large B cell lymphoma in a 46-year-old woman of African descent who is human immunodeficiency virus positive who presented with symptoms of superior vena cava syndrome. [jmedicalcasereports.biomedcentral.com]
Bone marrow or distant lymph node involvement at presentation is unusual [4]. [hindawi.com]
Entire Body System
- Fever
The patient, a 33-year-old man, had cough, dyspnea, fever, superior vena cava syndrome, and a mediastinal bulky tumor. A biopsy showed that the latter was characterized by large cells, sclerosis, and compartmentalization. [ncbi.nlm.nih.gov]
[…] if spleen involved IIIE if extralymphatic site involved Stage IV Diffuse or disseminated involvement of one or more extralymphatic organs or tissues, with or without associated lymph node involvement Systemic Symptoms in 6 months preceding admission Fever [surgpathcriteria.stanford.edu]
- Fatigue
The most common adverse reactions (reported in at least 20% of patients) were fatigue, decreased appetite, and dyspnea. [businesswire.com]
Clinical History A 15-year-old male patient presented with a 3-months history of shortness of breath, decreased appetite, fatigue and fever. A chest radiograph revealed a massive left-sided pleural effusion. [eurorad.org]
She also experienced fatigue, prominent facial swelling, engorged neck vasculature, headaches, and a 25-pound weight loss. Climbing even four individual stairs caused this former soccer athlete significant fatigue and lightheadedness. [hindawi.com]
The cause of the condition is also unknown, though genetic mutations have been implicated The condition can cause chest pain, breathing difficulties, fatigue, and other general signs and symptoms, such as fever, weight loss, and appetite loss. [dovemed.com]
- Chills
She denied having fevers, chills, or night sweats. She is a full-time college student living with her parents and sibling in Mexico. She was evaluated there and diagnosed with Cushing syndrome and hypothyroidism and was prescribed levothyroxine. [hindawi.com]
Monitor patients for signs and symptoms of infusion-related reactions, including rigors, chills, wheezing, pruritus, flushing, rash, hypotension, hypoxemia, and fever. For Grade 3 or 4 reactions, stop infusion and permanently discontinue KEYTRUDA. [businesswire.com]
Respiratoric
- Cough
PMLBCL is characterized by a locally invasive anterior mediastinal mass, often producing cough, chest pain, dyspnea, and superior vena cava syndrome. [moh-it.pure.elsevier.com]
Also called thymus gland. superior vena cava syndrome A group of symptoms that include coughing, difficulty breathing, headache, dizziness, fainting and swelling or flushing of the neck, face and upper arms. [cancer.ca]
The patient, a 33-year-old man, had cough, dyspnea, fever, superior vena cava syndrome, and a mediastinal bulky tumor. A biopsy showed that the latter was characterized by large cells, sclerosis, and compartmentalization. [ncbi.nlm.nih.gov]
- Pleural Effusion
Poor prognostic indicators are 1,2: advanced stage at diagnosis direct involvement of thoracic viscera infra-diaphragmatic spread pleural effusion Complications SVC syndrome respiratory compromise due to tracheal compression pleural effusions The differential [radiopaedia.org]
Other features include parenchymal invasion, pleural effusion, pericardial effusion, chest wall invasion, tracheal, oesophageal and vascular compression. [eurorad.org]
The two groups of patients were similar as regard to age, gender, presence of bulky mediastinal mass, pleural effusion, stage and international prognostic indexes category of risk. Overall, 75.5% of patients in CR received IF-RT as consolidation. [ncbi.nlm.nih.gov]
The disease typically presents with a bulky mediastinal mass and can be associated with pleural and pericardial effusions. [hematologyandoncology.net]
Imaging study showed a huge mediastinal mass and pleural effusions. In both patients, the tumor cells showed mature B cell phenotype, and histopathology in patient 2 showed diffuse large-cell lymphoma with sclerosis. [iss.ndl.go.jp]
- Dyspnea
PMLBCL is characterized by a locally invasive anterior mediastinal mass, often producing cough, chest pain, dyspnea, and superior vena cava syndrome. [moh-it.pure.elsevier.com]
The patient, a 33-year-old man, had cough, dyspnea, fever, superior vena cava syndrome, and a mediastinal bulky tumor. A biopsy showed that the latter was characterized by large cells, sclerosis, and compartmentalization. [ncbi.nlm.nih.gov]
[…] usually presents with a bulky and rapidly expanding anterior mediastinal mass, often with pleural and pericardial effusions, and that can invade the lungs, superior vena cava, pleura, pericardium, and chest wall, leading to manifestations of cough, dyspnea [orpha.net]
The most common adverse reactions (reported in at least 20% of patients) were fatigue, decreased appetite, and dyspnea. [businesswire.com]
- Mediastinal Disease
METHODS AND MATERIALS: Forty-one PMBCL patients underwent mediastinal IMRT after doxorubicin-based chemotherapy. Thirty-eight patients had stage I-II disease, and 3 patients had stage III-IV disease. [ncbi.nlm.nih.gov]
The patient with unusually late relapse received brief chemotherapy and IFRT for localized mediastinal disease 2.5 years after original diagnosis and is alive and free of disease now, 11 years post-relapse. [academic.oup.com]
- Hoarseness
This can cause: a cough aching in the chest breathlessness a hoarse voice swelling in the neck, arm or face dizziness headaches that are worse when bending forward. [macmillan.org.uk]
Gastrointestinal
- Loss of Appetite
The cause of the condition is also unknown, though genetic mutations have been implicated The condition can cause chest pain, breathing difficulties, fatigue, and other general signs and symptoms, such as fever, weight loss, and appetite loss. [dovemed.com]
Common symptoms breathlessness* cough or chest pain* fatigue loss of appetite enlarged lymph nodes - painless swelling in the neck, armpit or groin - often in more than one group. [lymphomation.org]
Around 1 in 3 people with DLBCL experience fevers, night sweats and unexplained weight loss. These are known as ‘B symptoms’. Fatigue and loss of appetite are also quite common, and some people experience severe itching. [lymphoma-action.org.uk]
- Dysphagia
[…] the pressure of the mass on the lungs or gut, or on the superior vena cava (the second largest vein in the body which returns blood from the upper half of the body to the heart).Symptoms include breathlessness, persistent cough, difficulty swallowing (dysphagia [leukaemia.org.au]
- Dysphagia
[…] the pressure of the mass on the lungs or gut, or on the superior vena cava (the second largest vein in the body which returns blood from the upper half of the body to the heart).Symptoms include breathlessness, persistent cough, difficulty swallowing (dysphagia [leukaemia.org.au]
Cardiovascular
- Chest Pain
PMLBCL is characterized by a locally invasive anterior mediastinal mass, often producing cough, chest pain, dyspnea, and superior vena cava syndrome. [moh-it.pure.elsevier.com]
The mass can cause symptoms as it grows bigger, such as: shortness of breath cough chest pain a partial blockage of the main vein that carries blood from the upper body to the heart (called the superior vena cava), which can lead to superior vena cava [cancer.ca]
PMBCL is a large, fast growing tumor that causes symptoms of cough, rapid breathing, difficulty in swallowing and chest pain which are due to the presence of the tumor mass and resulting compression of surrounding tissues. [drugs.com]
Skin
- Sweating
[…] involved IIIE if extralymphatic site involved Stage IV Diffuse or disseminated involvement of one or more extralymphatic organs or tissues, with or without associated lymph node involvement Systemic Symptoms in 6 months preceding admission Fever, night sweats [surgpathcriteria.stanford.edu]
She denied having fevers, chills, or night sweats. She is a full-time college student living with her parents and sibling in Mexico. She was evaluated there and diagnosed with Cushing syndrome and hypothyroidism and was prescribed levothyroxine. [hindawi.com]
Some people may also develop patches of inflamed skin across their body or experience fevers, night sweats and unexplained weight loss. [leukaemia.org.au]
B symptoms Some people also have: drenching night sweats high temperatures (fevers) with no obvious cause unexplained weight loss Doctors call this group of symptoms B symptoms. [macmillan.org.uk]
Around 1 in 3 people with DLBCL experience fevers, night sweats and unexplained weight loss. These are known as ‘B symptoms’. Fatigue and loss of appetite are also quite common, and some people experience severe itching. [lymphoma-action.org.uk]
- Skin Rash
Additionally, there may also be the following general signs and symptoms: Fatigue and weakness, headache Anemia (low red blood cell count) Frequent infections Low blood pressure Pain in the abdomen, bones Itchy skin rashes Enlarged lymph nodes that may [dovemed.com]
Psychiatrical
- Aggressive Behavior
behavior and poorer response to treatment than other large-cell lymphomas, although the overall response to chemotherapy and/or radiotherapy is still good 1,2. [radiopaedia.org]
Go to: TOC Prev Next Diffuse Large B-Cell Lymphoma (DLBCL) W ITH this section we step gingerly into the territory of lymphomas Aggressive histology that are aggressive in histology and clinical behavior. [rwjmsweb.rwjms.rutgers.edu]
Neurologic
- Peripheral Neuropathy
Other adverse events included peripheral neuropathy, thrombocytopenia, rash, peripheral sensory neuropathy and hyperthyroidism. [healio.com]
Six patients (40%) experienced adverse events associated with BV treatment, including peripheral neuropathy (n=1), atrial fibrillation (n=1), increase in alanine transaminase (n=2), increase in gamma-glutamyltransferase (n=2), and anemia (n=2). [ashclinicalnews.org]
As in HL, BV has been trialled as an adjunct to first‐line R‐CHP (vincristine omitted to reduce risk of peripheral neuropathy) in CD30‐positive PMBCL, DLBCL and grey zone lymphoma. [doi.org]
Workup
Workup of such cases should include extended panel of immunohistochemical stains including the B-cell transcription factors PAX-5, OCT-2 and BOB.1. [arup.utah.edu]
X-Ray
- Pericardial Effusion
Our simple indicators of International Prognostic Index score and the presence of pleural or pericardial effusion could stratify patients with primary mediastinal large B-cell lymphoma and help guide selection of treatment. [ncbi.nlm.nih.gov]
Most PMLBCL patients have stage I-II, bulky disease, with pleural or pericardial effusions in a third of cases. [moh-it.pure.elsevier.com]
Other features include parenchymal invasion, pleural effusion, pericardial effusion, chest wall invasion, tracheal, oesophageal and vascular compression. [eurorad.org]
The presence of pleural or pericardial effusions has been proposed as a negative prognostic indicator. [connect.springerpub.com]
Pleura
- Pleural Effusion
Poor prognostic indicators are 1,2: advanced stage at diagnosis direct involvement of thoracic viscera infra-diaphragmatic spread pleural effusion Complications SVC syndrome respiratory compromise due to tracheal compression pleural effusions The differential [radiopaedia.org]
Other features include parenchymal invasion, pleural effusion, pericardial effusion, chest wall invasion, tracheal, oesophageal and vascular compression. [eurorad.org]
The two groups of patients were similar as regard to age, gender, presence of bulky mediastinal mass, pleural effusion, stage and international prognostic indexes category of risk. Overall, 75.5% of patients in CR received IF-RT as consolidation. [ncbi.nlm.nih.gov]
The disease typically presents with a bulky mediastinal mass and can be associated with pleural and pericardial effusions. [hematologyandoncology.net]
Imaging study showed a huge mediastinal mass and pleural effusions. In both patients, the tumor cells showed mature B cell phenotype, and histopathology in patient 2 showed diffuse large-cell lymphoma with sclerosis. [iss.ndl.go.jp]
Treatment
CONCLUSIONS: Our data indicate that a third-generation regimen like MACOP-B could be considered a suitable first-line treatment. [ncbi.nlm.nih.gov]
You may have some treatments as part of a clinical trial. PMBCL usually responds well to treatment. But if it does not respond or if the lymphoma comes back, you will need more treatment. [macmillan.org.uk]
Prognosis
The prognosis and therapy of patients with PMLBCL is still controversial. We summarize our experience with PMLBCL at the Medical University of South Carolina between 1997 and 2000. [ncbi.nlm.nih.gov]
[…] abbreviated PMBL, is a rare type of lymphoma that forms in the mediastinum (the space in between the lungs) and predominantly affects young adults.[1][2] It is a subtype of diffuse large B-cell lymphoma;[3] however, it generally has a significantly better prognosis [en.wikipedia.org]
H&O What is the prognosis? RA Overall, the prognosis is good, with a high response rate. Approximately 90% of patients are cured with contemporary therapies. [hematologyandoncology.net]
Etiology
The use of tocilizumab directed at IL-6 has been shown to mitigate CRS, but the etiology and treatment of neurologic complications remain more elusive. [hematology.org]
[…] unspecified site ICD-10: C85.29 - mediastinal (thymic) large B cell lymphoma, extranodal and solid organ sites Sites Presents with localized anterosuperior mediastinal mass arising in thymic area Regional supraclavicular and cervical lymph node involvement Etiology [pathologyoutlines.com]
For suspected immune-mediated adverse reactions, ensure adequate evaluation to confirm etiology or exclude other causes. Based on the severity of the adverse reaction, withhold KEYTRUDA (pembrolizumab) and administer corticosteroids. [businesswire.com]
(Etiology) Lymphocytes are a type of white blood cells that are responsible for providing immunity in the human body. B-cells and T-cells are the two different types of lymphocytes. [dovemed.com]
Epidemiology
Gov't MeSH terms B7-H1 Antigen/genetics* Cell Line, Tumor Chromosomes, Human, Pair 9 DNA Copy Number Variations Gene Expression Regulation, Neoplastic Gene Frequency Humans In Situ Hybridization, Fluorescence Lymphoma, Large B-Cell, Diffuse/epidemiology [ncbi.nlm.nih.gov]
navigation, search Primary mediastinal large B-cell lymphoma Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Primary Mediastinal Large B-cell Lymphoma from other Diseases Epidemiology [wikidoc.org]
Pathophysiology
(Redirected from Mediastinal large B-cell lymphoma ) Jump to: navigation, search Primary mediastinal large B-cell lymphoma Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Primary [wikidoc.org]
[…] diffuse large B-cell lymphoma involving the mediastinum, recognized in the WHO 2008 classification.[1][2]:370–374 Signs and symptoms[edit] Superior vena cava syndrome occurs in 30–50%, and pleural or pericardial effusions occur in about one-third.[3] Pathophysiology [en.wikipedia.org]
Prevention
This case suggests that long-term administration of an LMWH contributes to the primary improvement and secondary prevention of VTE even in patients who are at high risk for thrombosis. [ncbi.nlm.nih.gov]
How can Primary Mediastinal Large B-Cell Lymphoma be Prevented? Currently, it is not possible to prevent Primary Mediastinal Large B-Cell Lymphoma. However, controlling certain factors may help lower one’s risk for the condition. [dovemed.com]