Skip to main content

Mediastinal Lymphoma

  • Chapter
  • First Online:
The Mediastinal Mass

Part of the book series: Current Clinical Pathology ((CCPATH))

  • 579 Accesses

Abstract

There is a group of Hodgkin and non-Hodgkin lymphoma that can initially manifest themselves as a primary mediastinal disease. These include nodular sclerosis Hodgkin lymphoma (NSHL); primary mediastinal large B-cell lymphoma (PMLBCL); B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classic Hodgkin lymphoma; thymic marginal zone B-cell lymphoma (MZL); and T-lymphoblastic lymphoma (T-LL).

Here we review the main aspects of these different conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Inagaki H, Chan JK, Ng JW, Okabe M, Yoshino T, Okamoto M, et al. Primary thymic extranodal marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue type exhibits distinctive clinicopathological and molecular features. Am J Pathol. 2002;160(4):1435–43.

    Article  Google Scholar 

  2. Balakrishna JP, Jaffe ES. Crystal-storing histiocytosis associated with thymic extranodal marginal zone lymphoma. Blood. 2017;130(14):1683.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Go H, Cho HJ, Paik JH, Park CM, Oh YH, Jung KC, et al. Thymic extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue: a clinicopathological and genetic analysis of six cases. Leuk Lymphoma. 2011;52(12):2276–83.

    Article  CAS  Google Scholar 

  4. Kominato S, Nakayama T, Sato F, Yamada S, Xia H, Fujiyoshi Y, et al. Characterization of chromosomal aberrations in thymic MALT lymphoma. Pathol Int. 2012;62(2):93–8.

    Article  CAS  Google Scholar 

  5. Takino H, Li C, Yamada S, Sato F, Masaki A, Fujiyoshi Y, et al. Thymic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue: a gene methylation study. Leuk Lymphoma. 2013;54(8):1742–6.

    Article  CAS  Google Scholar 

  6. Eberle FC, Mani H, Jaffe ES. Histopathology of Hodgkin’s lymphoma. Cancer J. 2009;15(2):129–37.

    Article  Google Scholar 

  7. Colby TV, Hoppe RT, Warnke RA. Hodgkin’s disease: a clinicopathologic study of 659 cases. Cancer. 1982;49(9):1848–58.

    Article  CAS  Google Scholar 

  8. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375–90.

    Article  CAS  Google Scholar 

  9. Strickler JG, Michie SA, Warnke RA, Dorfman RF. The “syncytial variant” of nodular sclerosing Hodgkin’s disease. Am J Surg Pathol. 1986;10(7):470–7.

    Article  CAS  Google Scholar 

  10. Masih AS, Weisenburger DD, Vose JM, Bast MA, Armitage JO. Histologic grade does not predict prognosis in optimally treated, advanced-stage nodular sclerosing Hodgkin’s disease. Cancer. 1992;69(1):228–32.

    Article  CAS  Google Scholar 

  11. Dorfman DM, Shahsafaei A, Alonso MA. Utility of CD200 immunostaining in the diagnosis of primary mediastinal large B cell lymphoma: comparison with MAL, CD23, and other markers. Mod Pathol. 2012;25(12):1637–43.

    Article  CAS  Google Scholar 

  12. Wang Z, Cook JR. PDCD1LG2 (PD-L2) RNA in situ hybridization is a sensitive, specific, and practical marker of primary mediastinal large B-cell lymphoma. Br J Haematol. 2017.

    Google Scholar 

  13. Ritz O, Guiter C, Castellano F, Dorsch K, Melzner J, Jais JP, et al. Recurrent mutations of the STAT6 DNA binding domain in primary mediastinal B-cell lymphoma. Blood. 2009;114(6):1236–42.

    Article  CAS  Google Scholar 

  14. Guiter C, Dusanter-Fourt I, Copie-Bergman C, Boulland ML, Le Gouvello S, Gaulard P, et al. Constitutive STAT6 activation in primary mediastinal large B-cell lymphoma. Blood. 2004;104(2):543–9.

    Article  CAS  Google Scholar 

  15. Mestre C, Rubio-Moscardo F, Rosenwald A, Climent J, Dyer MJ, Staudt L, et al. Homozygous deletion of SOCS1 in primary mediastinal B-cell lymphoma detected by CGH to BAC microarrays. Leukemia. 2005;19(6):1082–4.

    Article  CAS  Google Scholar 

  16. Mottok A, Woolcock B, Chan FC, Tong KM, Chong L, Farinha P, et al. Genomic alterations in CIITA are frequent in primary mediastinal large B cell lymphoma and are associated with diminished MHC class II expression. Cell Rep. 2015;13(7):1418–31.

    Article  CAS  Google Scholar 

  17. Yuan J, Wright G, Rosenwald A, Steidl C, Gascoyne RD, Connors JM, et al. Identification of primary mediastinal large B-cell lymphoma at nonmediastinal sites by gene expression profiling. Am J Surg Pathol. 2015;39(10):1322–30.

    Article  Google Scholar 

  18. Pelland K, Mathews S, Kamath A, Cohen P, Hudnall SD, Cotta CV, et al. Dendritic cell markers and PD-L1 are expressed in mediastinal gray zone lymphoma. Appl Immunohistochem Mol Morphol. 2017.

    Google Scholar 

  19. Garcia JF, Mollejo M, Fraga M, Forteza J, Muniesa JA, Perez-Guillermo M, et al. Large B-cell lymphoma with Hodgkin’s features. Histopathology. 2005;47(1):101–10.

    Article  CAS  Google Scholar 

  20. Traverse-Glehen A, Pittaluga S, Gaulard P, Sorbara L, Alonso MA, Raffeld M, et al. Mediastinal gray zone lymphoma: the missing link between classic Hodgkin’s lymphoma and mediastinal large B-cell lymphoma. Am J Surg Pathol. 2005;29(11):1411–21.

    Article  Google Scholar 

  21. Song HN, Kim SJ, Ko YH, Kim WS. Mediastinal gray zone lymphoma with features intermediate between classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma. Acta Haematol. 2016;136(3):186–90.

    Article  CAS  Google Scholar 

  22. Sarkozy C, Molina T, Ghesquieres H, Michallet AS, Dupuis J, Damotte D, et al. Mediastinal gray zone lymphoma: clinico-pathological characteristics and outcomes of 99 patients from the Lymphoma Study Association. Haematologica. 2017;102(1):150–9.

    Article  Google Scholar 

  23. O’Malley DP, Fedoriw Y, Weiss LM. Distinguishing classical Hodgkin lymphoma, gray zone lymphoma, and large B-cell lymphoma: a proposed scoring system. Appl Immunohistochem Mol Morphol. 2016;24(8):535–40.

    Article  Google Scholar 

  24. Chihara D, Westin JR, Miranda RN, Cheah CY, Oki Y, Turturro F, et al. Dose adjusted-EPOCH-R and mediastinal disease may improve outcomes for patients with gray-zone lymphoma. Br J Haematol. 2017;179(3):503–6.

    Article  Google Scholar 

  25. Wilson WH, Pittaluga S, Nicolae A, Camphausen K, Shovlin M, Steinberg SM, et al. A prospective study of mediastinal gray-zone lymphoma. Blood. 2014;124(10):1563–9.

    Article  CAS  Google Scholar 

  26. Melani C, Major A, Schowinsky J, Roschewski M, Pittaluga S, Jaffe ES, et al. PD-1 blockade in mediastinal gray-zone lymphoma. N Engl J Med. 2017;377(1):89–91.

    Article  Google Scholar 

  27. Vitale A, Guarini A, Ariola C, Mancini M, Mecucci C, Cuneo A, et al. Adult T-cell acute lymphoblastic leukemia: biologic profile at presentation and correlation with response to induction treatment in patients enrolled in the GIMEMA LAL 0496 protocol. Blood. 2006;107(2):473–9.

    Article  CAS  Google Scholar 

  28. Marks DI, Paietta EM, Moorman AV, Richards SM, Buck G, DeWald G, et al. T-cell acute lymphoblastic leukemia in adults: clinical features, immunophenotype, cytogenetics, and outcome from the large randomized prospective trial (UKALL XII/ECOG 2993). Blood. 2009;114(25):5136–45.

    Article  CAS  Google Scholar 

  29. Stein H, Petersen N, Gaedicke G, Lennert K, Landbeck G. Lymphoblastic lymphoma of convoluted or acid phosphatase type-a tumor of T precursor cells. Int J Cancer. 1976;17(3):292–5.

    Article  CAS  Google Scholar 

  30. Weng AP, Ferrando AA, Lee W, Morris JP IV, Silverman LB, Sanchez-Irizarry C, et al. Activating mutations of NOTCH1 in human T cell acute lymphoblastic leukemia. Science. 2004;306(5694):269–71.

    Article  CAS  Google Scholar 

  31. Ohgami RS, Arber DA, Zehnder JL, Natkunam Y, Warnke RA. Indolent T-lymphoblastic proliferation (iT-LBP): a review of clinical and pathologic features and distinction from malignant T-lymphoblastic lymphoma. Adv Anat Pathol. 2013;20(3):137–40.

    Article  CAS  Google Scholar 

  32. Eberle FC, Salaverria I, Steidl C, Summers TA Jr, Pittaluga S, Neriah SB, et al. Gray zone lymphoma: chromosomal aberrations with immunophenotypic and clinical correlations. Mod Pathol. 2011;24(12):1586–97.

    Article  CAS  Google Scholar 

  33. Steidl C, Shah SP, Woolcock BW, Rui L, Kawahara M, Farinha P, et al. MHC class II transactivator CIITA is a recurrent gene fusion partner in lymphoid cancers. Nature. 2011;471(7338):377–81.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

This work was supported by grants from the Instituto de Salud Carlos III (ISCIII) of the Spanish Ministry of Economy and Competence (MINECO, RTICC ISCIII, and CIBERONC) (SAF2013-47416-R, RD06/0020/0107-RD012/0036/0060, and Plan Nacional I + D + I: PI16/01294 and PIE15/0081) and the Asociación Española Contra el Cáncer (AECC).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Miguel A. Piris .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Piris, M.A., Muñoz, J., Rodríguez-Pinilla, S.M. (2018). Mediastinal Lymphoma. In: Franco, R., Zito Marino, F., Giordano, A. (eds) The Mediastinal Mass. Current Clinical Pathology. Humana, Cham. https://doi.org/10.1007/978-3-319-90368-2_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90368-2_13

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-319-90367-5

  • Online ISBN: 978-3-319-90368-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics