Primary mediastinal large B-cell lymphoma, classic Hodgkin lymphoma presenting in the mediastinum, and mediastinal gray zone lymphoma: what is the oncologist to do? - PubMed (original) (raw)

Review

Primary mediastinal large B-cell lymphoma, classic Hodgkin lymphoma presenting in the mediastinum, and mediastinal gray zone lymphoma: what is the oncologist to do?

Cliona Grant et al. Curr Hematol Malig Rep. 2011 Sep.

Abstract

In recent years, an overlap in biologic and clinical features has been identified between classic Hodgkin lymphoma (CHL) and primary mediastinal large B-cell lymphoma (PMBL). Further strengthening this relationship is the identification of lymphomas with clinical and morphologic features transitional between the two, known as gray zone lymphomas (GZL). However, this diagnostic gray zone is not just of theoretical interest: it presents a practical problem, as the treatment approaches for CHL traditionally differ from those for aggressive B-cell lymphomas. This article reviews the treatment approach for mediastinal lymphomas, including CHL of the nodular sclerosis subtype (CHL-NS), PMBL, and mediastinal GZL. Though several trials have evaluated different regimens with or without radiation in PMBL and CHL-NS, there is a lack of prospective experience in treating GZL because of the rarity of these tumors. Historical data indicate that they have done poorly with traditional approaches developed for the treatment of either CHL or diffuse large B-cell lymphoma.

PubMed Disclaimer

Conflict of interest statement

Disclosure No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1

Fig. 1

Interrelationships among mediastinal lymphomas. Primary mediastinal large B-cell lymphoma (PMBL), classic Hodgkin lymphoma of the nodular sclerosis subtype (CHL-NS), and mediastinal gray zone lymphomas are all thought to be derived from a thymic B cell. In a given patient, differing histologic patterns can be seen at different times, suggesting plasticity in tumor cell phenotype and gene expression. Composite lymphomas of CHL-NS and PMBL may also be seen

Similar articles

Cited by

References

    1. Campo E, Swerdlow SH, Harris NL, et al. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood February 7 2011. (Epub ahead of print).
      This review discusses new concepts introduced into the 2008 WHO classification, including the concept of mediastinal gray zone lymphomas.
    1. Rudiger T, Jaffe ES, Delsol G, et al. Workshop report on Hodgkin’s disease and related diseases (‘grey zone’ lymphoma). Ann Oncol 1998;9 Suppl 5:S31–8. - PubMed
    1. Jaffe ES, Zarate-Osorno A, Medeiros LJ. The interrelationship of Hodgkin’s disease and non-Hodgkin’s lymphomas–lessons learned from composite and sequential malignancies. Semin Diagn Pathol 1992;9:297–303. - PubMed
    1. Kuppers R. The biology of Hodgkin’s lymphoma. Nat Rev Cancer 2009;9:15–27.
      This article is an excellent review on the biology of Hodgkin’s lymphoma.
    1. Kanzler H, Kuppers R, Hansmann ML, Rajewsky K. Hodgkin and Reed-Sternberg cells in Hodgkin’s disease represent the outgrowth of a dominant tumor clone derived from (crippled) germinal center B cells. J Exp Med 1996;184:1495–505. - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources