Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes

Diagnosis and treatment

Ya K. Mangasarova, A. U. Magomedova, S. K. Kravchenko, E. E. Zvonkov, A. M. Kremenetskaya, V. I. Vorobyev, D. S. Maryin, A. V. Gubkin, N. I. Skidan, I. B. Kaplanskaya, I. A. Vorobyev, R. S. Samoilova, A. I. Vorobyev

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aim. To diagnose diffuse large B-cell lymphosarcoma (DLBCLS) with primary involvement of the mediastinal lymph nodes (LN) and to evaluate the efficiency of aggressive polychemotherapy (PCT). Subjects and methods. The study included 15 patients (6 men and 9 women aged 18 to 70 years; median 38 years) followed up at the Hematology Research Center, Russian Academy of Medical Sciences, in 2004 to 2009. Three and 12 patients had Stages II and HE DLBCLS, respectively. B symptoms were found in 14 (93.4%) patients. Increased lactate dehydrogenase (LDH) concentrations were detectable in 14 (93.4%) patients; tumors of 10 cm or more (bulky disease) were seen in 11 (73.3%). Enlarged cervical, supraclavicular, and axillary lymph nodes were found in 9 (60%) patients; lung involvement via extension in 9 (60%), and invasion into the pericardium in 5 (33.3%) and soft tissues of the anterior thoracic wall in (13.3%). There were no signs of involvement of extranodal organs at the moment of diagnosis. All the 15 patients received PCT according to the modified NHL-BFM-90 program: 4 to 6 courses depending on the response to the therapy; 10 (66.6%) and 5 (33.3%) patients had 4 and 6 courses, respectively; for consolidating purpose, 11 (78.5%) patients were prescribed radiotherapy applied to the mediastinum in a cumulative dose of 36 Gy due to the fact that they had a residual mass. Results. Thirteen (86.6%) patients achieved a complete remission (CR). Primary PCTresistance was confirmed in one case. Another patient was stated to have near-complete remission. No recurrences were notified during the follow-up. The mean CR duration was 24.5 (range 2-49) months. Conclusion. DLBCLS with primary LN involvement is an individual nosological entity to be differentiated from primary mediastinal large B-cell lymphosarcoma. In most cases, DLBCLS shows signs of a poor prognosis, which makes it necessary to perform aggressive PCT.

Original languageEnglish
Pages (from-to)61-65
Number of pages5
JournalTerapevticheskii Arkhiv
Volume82
Issue number7
Publication statusPublished - 2010
Externally publishedYes

Fingerprint

Lymphoma, Large B-Cell, Diffuse
Lymph Nodes
Non-Hodgkin's Lymphoma
B-Lymphocytes
Combination Drug Therapy
Therapeutics
Pericardium
Mediastinum
Thoracic Wall
Hematology
L-Lactate Dehydrogenase
Radiotherapy
Recurrence
Lung

Keywords

  • Diffuse large b-cell lymphosarcoma
  • MNHL-BFM-90
  • Primary mediastinal lymphosarcoma
  • Radiotherapy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mangasarova, Y. K., Magomedova, A. U., Kravchenko, S. K., Zvonkov, E. E., Kremenetskaya, A. M., Vorobyev, V. I., ... Vorobyev, A. I. (2010). Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes: Diagnosis and treatment. Terapevticheskii Arkhiv, 82(7), 61-65.

Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes : Diagnosis and treatment. / Mangasarova, Ya K.; Magomedova, A. U.; Kravchenko, S. K.; Zvonkov, E. E.; Kremenetskaya, A. M.; Vorobyev, V. I.; Maryin, D. S.; Gubkin, A. V.; Skidan, N. I.; Kaplanskaya, I. B.; Vorobyev, I. A.; Samoilova, R. S.; Vorobyev, A. I.

In: Terapevticheskii Arkhiv, Vol. 82, No. 7, 2010, p. 61-65.

Research output: Contribution to journalArticle

Mangasarova, YK, Magomedova, AU, Kravchenko, SK, Zvonkov, EE, Kremenetskaya, AM, Vorobyev, VI, Maryin, DS, Gubkin, AV, Skidan, NI, Kaplanskaya, IB, Vorobyev, IA, Samoilova, RS & Vorobyev, AI 2010, 'Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes: Diagnosis and treatment', Terapevticheskii Arkhiv, vol. 82, no. 7, pp. 61-65.
Mangasarova YK, Magomedova AU, Kravchenko SK, Zvonkov EE, Kremenetskaya AM, Vorobyev VI et al. Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes: Diagnosis and treatment. Terapevticheskii Arkhiv. 2010;82(7):61-65.
Mangasarova, Ya K. ; Magomedova, A. U. ; Kravchenko, S. K. ; Zvonkov, E. E. ; Kremenetskaya, A. M. ; Vorobyev, V. I. ; Maryin, D. S. ; Gubkin, A. V. ; Skidan, N. I. ; Kaplanskaya, I. B. ; Vorobyev, I. A. ; Samoilova, R. S. ; Vorobyev, A. I. / Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes : Diagnosis and treatment. In: Terapevticheskii Arkhiv. 2010 ; Vol. 82, No. 7. pp. 61-65.
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abstract = "Aim. To diagnose diffuse large B-cell lymphosarcoma (DLBCLS) with primary involvement of the mediastinal lymph nodes (LN) and to evaluate the efficiency of aggressive polychemotherapy (PCT). Subjects and methods. The study included 15 patients (6 men and 9 women aged 18 to 70 years; median 38 years) followed up at the Hematology Research Center, Russian Academy of Medical Sciences, in 2004 to 2009. Three and 12 patients had Stages II and HE DLBCLS, respectively. B symptoms were found in 14 (93.4{\%}) patients. Increased lactate dehydrogenase (LDH) concentrations were detectable in 14 (93.4{\%}) patients; tumors of 10 cm or more (bulky disease) were seen in 11 (73.3{\%}). Enlarged cervical, supraclavicular, and axillary lymph nodes were found in 9 (60{\%}) patients; lung involvement via extension in 9 (60{\%}), and invasion into the pericardium in 5 (33.3{\%}) and soft tissues of the anterior thoracic wall in (13.3{\%}). There were no signs of involvement of extranodal organs at the moment of diagnosis. All the 15 patients received PCT according to the modified NHL-BFM-90 program: 4 to 6 courses depending on the response to the therapy; 10 (66.6{\%}) and 5 (33.3{\%}) patients had 4 and 6 courses, respectively; for consolidating purpose, 11 (78.5{\%}) patients were prescribed radiotherapy applied to the mediastinum in a cumulative dose of 36 Gy due to the fact that they had a residual mass. Results. Thirteen (86.6{\%}) patients achieved a complete remission (CR). Primary PCTresistance was confirmed in one case. Another patient was stated to have near-complete remission. No recurrences were notified during the follow-up. The mean CR duration was 24.5 (range 2-49) months. Conclusion. DLBCLS with primary LN involvement is an individual nosological entity to be differentiated from primary mediastinal large B-cell lymphosarcoma. In most cases, DLBCLS shows signs of a poor prognosis, which makes it necessary to perform aggressive PCT.",
keywords = "Diffuse large b-cell lymphosarcoma, MNHL-BFM-90, Primary mediastinal lymphosarcoma, Radiotherapy",
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T1 - Diffuse large B-cell lymphoma with primary involvement of mediastinal lymph nodes

T2 - Diagnosis and treatment

AU - Mangasarova, Ya K.

AU - Magomedova, A. U.

AU - Kravchenko, S. K.

AU - Zvonkov, E. E.

AU - Kremenetskaya, A. M.

AU - Vorobyev, V. I.

AU - Maryin, D. S.

AU - Gubkin, A. V.

AU - Skidan, N. I.

AU - Kaplanskaya, I. B.

AU - Vorobyev, I. A.

AU - Samoilova, R. S.

AU - Vorobyev, A. I.

PY - 2010

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N2 - Aim. To diagnose diffuse large B-cell lymphosarcoma (DLBCLS) with primary involvement of the mediastinal lymph nodes (LN) and to evaluate the efficiency of aggressive polychemotherapy (PCT). Subjects and methods. The study included 15 patients (6 men and 9 women aged 18 to 70 years; median 38 years) followed up at the Hematology Research Center, Russian Academy of Medical Sciences, in 2004 to 2009. Three and 12 patients had Stages II and HE DLBCLS, respectively. B symptoms were found in 14 (93.4%) patients. Increased lactate dehydrogenase (LDH) concentrations were detectable in 14 (93.4%) patients; tumors of 10 cm or more (bulky disease) were seen in 11 (73.3%). Enlarged cervical, supraclavicular, and axillary lymph nodes were found in 9 (60%) patients; lung involvement via extension in 9 (60%), and invasion into the pericardium in 5 (33.3%) and soft tissues of the anterior thoracic wall in (13.3%). There were no signs of involvement of extranodal organs at the moment of diagnosis. All the 15 patients received PCT according to the modified NHL-BFM-90 program: 4 to 6 courses depending on the response to the therapy; 10 (66.6%) and 5 (33.3%) patients had 4 and 6 courses, respectively; for consolidating purpose, 11 (78.5%) patients were prescribed radiotherapy applied to the mediastinum in a cumulative dose of 36 Gy due to the fact that they had a residual mass. Results. Thirteen (86.6%) patients achieved a complete remission (CR). Primary PCTresistance was confirmed in one case. Another patient was stated to have near-complete remission. No recurrences were notified during the follow-up. The mean CR duration was 24.5 (range 2-49) months. Conclusion. DLBCLS with primary LN involvement is an individual nosological entity to be differentiated from primary mediastinal large B-cell lymphosarcoma. In most cases, DLBCLS shows signs of a poor prognosis, which makes it necessary to perform aggressive PCT.

AB - Aim. To diagnose diffuse large B-cell lymphosarcoma (DLBCLS) with primary involvement of the mediastinal lymph nodes (LN) and to evaluate the efficiency of aggressive polychemotherapy (PCT). Subjects and methods. The study included 15 patients (6 men and 9 women aged 18 to 70 years; median 38 years) followed up at the Hematology Research Center, Russian Academy of Medical Sciences, in 2004 to 2009. Three and 12 patients had Stages II and HE DLBCLS, respectively. B symptoms were found in 14 (93.4%) patients. Increased lactate dehydrogenase (LDH) concentrations were detectable in 14 (93.4%) patients; tumors of 10 cm or more (bulky disease) were seen in 11 (73.3%). Enlarged cervical, supraclavicular, and axillary lymph nodes were found in 9 (60%) patients; lung involvement via extension in 9 (60%), and invasion into the pericardium in 5 (33.3%) and soft tissues of the anterior thoracic wall in (13.3%). There were no signs of involvement of extranodal organs at the moment of diagnosis. All the 15 patients received PCT according to the modified NHL-BFM-90 program: 4 to 6 courses depending on the response to the therapy; 10 (66.6%) and 5 (33.3%) patients had 4 and 6 courses, respectively; for consolidating purpose, 11 (78.5%) patients were prescribed radiotherapy applied to the mediastinum in a cumulative dose of 36 Gy due to the fact that they had a residual mass. Results. Thirteen (86.6%) patients achieved a complete remission (CR). Primary PCTresistance was confirmed in one case. Another patient was stated to have near-complete remission. No recurrences were notified during the follow-up. The mean CR duration was 24.5 (range 2-49) months. Conclusion. DLBCLS with primary LN involvement is an individual nosological entity to be differentiated from primary mediastinal large B-cell lymphosarcoma. In most cases, DLBCLS shows signs of a poor prognosis, which makes it necessary to perform aggressive PCT.

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