Successful high dose therapy for relapsed mediastinal large B cell lymphoma following surgical repair of anterior chest wall defect

We describe a man with relapsed large B cell mediastinal lymphoma and assoc iated infected large anterior chest wall defect who required high dose salv age therapy for his underlying disease. An initial mediastinotomy wound, as sociated with recurrent sepsis, had developed into an abscess, then fistula and eventually a large anterior chest wall defect. Safe use of salvage che motherapy required reconstructive surgery consisting of a pedicled muscle f lap. The subsequent high dose chemotherapy was carried out without complica tions and 15 months later the patient is alive and well.