Primary mediastinal non Hodgkin's lymphoma: clinicopathologic study and response to treatment

ABSTRACT

Out of 982 histologically confirmed cases of malignant lymphoma presenting to NEMROCK between 1970-1981 inclusive, non-Hodgkin's lymphoma constituted 59.5% [585 cases]. Among this later group, 66 patients had intrathoracic disease. Primary mediastinal NHL represented 6.2% of NHL [36 cases]. The male to female ratio was 2.61 with the peak age incidence in the third decade of life. Lymphoblastic lymphoma was the main histological subtype of primary mediastinal NHL, 42.9% of the histologically revised group [21 cases]. The main presenting symptoms were those of mediastinal syndrome. Bone marrow infiltration was recorded either initially or subsequently in 50%. Advanced stages predominated early ones [69.7% versus 30.3%]. Leukemic transformation was recorded in 38.9% of cases of primary mediastinal NHL [14 cases]. The overall infiltration of CNS was 14% of cases. However, the overall complete and partial remission [CR and PR] at end of treatment was 20% and 32% respectively. Response rate [CR and PR] was only 25% among the lymphoblastic group. Early stages [I and II] responded favorably to treatment than later stages [III and IV] with an overall response of 72% versus 45% respectively. Comparison between clinical features and response to treatment of the lymphoblastic and other histological subtype of primary mediastinal NHL was carried out