MEDIASTINAL LARGE B-CELL LYMPHOMA - A CLI NICOPATHOLOGICAL REVIEW OF 26 CASES

Mediastinal B-cell lymphomas (with or without sclerosis) have been rec ently recognized as an entity with particular clinical features. We re port 26 patients with a mediastinal large B-cell lymphoma. They repres ent 5% of the patients with aggressive non-Hodgkin's lymphoma and 2% o f all non-Hodgkin's lymphoma seen in our centre between 1962 and 1990. They include 19 females (73%) and 7 males (27%). The sex ratio was 2. 7 and the median age was 44 years (range: 17-84 years). Compressive sy mptoms in relation with a bulky mediastinum were present in 21 cases ( 80%) and with B symptoms in 5 cases. All these patients received 2 to 4 cycles of chemotherapy with a CHOP-like protocol (epirubicin or doxo rubicin, cyclophosphamide, vincristine and prednisone) followed in 24 cases by mediastinum irradiation (40 Gy). Two patients progressed duri ng chemotherapy and did not receive radiotherapy. Nineteen patients ha d a consolidation chemotherapy according to the same Protocol. Twenty- one patients achieved a complete remission after chemotherapy or radio therapy and 5 failed. Two patients relapsed at 10 months and 9 years. Seventeen patients are alive and in first complete remission with a me dian follow-up of 102 months (range: 60-260 months). Using the Kaplan- Meier method the overall survival at 5 and 10 years was respectively 7 7 and 61% and the relapse-free survival was respectively 68 and 57%. T hese results confirm the previous findings concerning this distinct en tity which is characterized by a predilection for young women, compres sive symptoms, a slow response to treatment and a rather good prognosi s.