Lymphoma and plasma cell neoplasms
B cell lymphoma subtypes
Mediastinal (thymic) large B cell lymphoma

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 3 April 2017, last major update February 2011

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PubMed Search: mediastinal (thymic) large B cell lymphoma

Cite this page: Mediastinal (thymic) large B cell lymphoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphomamediastinal.html. Accessed October 21st, 2017.
Definition / general
  • A type of diffuse large B cell lymphoma, often presents as antero-superior mediastinal mass, superior vena cava syndrome or tracheobronchial compression
  • Absence of lymph node or bone marrow involvement essential to exclude secondary involvement by diffuse large B cell lymphoma
Epidemiology
  • Young adults, 2/3 female
Etiology
Clinical features
  • Aggressive; 50% present with stage 1 or 2 disease
  • Poor prognosis, with adjacent thoracic visceral involvement, pleural or pericardial effusion
  • 5 year survival is 50%, with relapses to kidney, breast, adrenal cortex, ovary, liver, pancreas, GI
Gross description
  • Large, bulky, locally invasive, often fibrotic
Microscopic (histologic) description
  • Pleomorphic large cells including centroblasts and immunoblasts with abundant cytoplasm and distinct cell borders
  • Oval, cleaved or multilobated nuclei resembling Reed-Sternberg cells
  • Also histiocytes, small lymphocytes, sclerosis
  • Variable residual thymic tissue
Positive stains
Negative stains
Molecular / cytogenetics description
  • Clonal IgH and IgL rearrangements, 9p24 and 2p15 amplification involving REL and BCL11A genes respectively
Differential diagnosis