Mediastinal Malignant Lymphoma

Abstract

Ninety-seven cases of malignant lymphoma, clinically presenting in the mediastinum, were diagnosed by examination of surgical pathologic specimens. These specimens were analyzed in the light of newer concepts regarding lymphoma, including current classification and clinical staging of these tumors. The influences of clinical and histopathologic features and therapeutic modalities were assessed in regard to prognosis. Fifty-seven patients had Hodgkin's disease and 61.3 percent of these patients survived five years, whereas 40 patients had lymphosarcomas and only 15 percent of these patients survived five years. Generally, mature lymphocytic predominance of lymphomas and nodularity, particularly in lymphosarcoma, were histopathologic features that were associated with increased survival. Nodular sclerosis was noted in 35 of the patients and mixed cellularity in 19, and these patients had favorable survival rates. Thirteen of the 15 patients with lymphoma of stage I survived five years. Five of the six patients with thymic Hodgkin's disease treated by surgical excision and roentgen therapy survived five years or more. Radical surgery has a distinct place in the therapy of selected patients with mediastinal lymphoma. Ninety-seven cases of malignant lymphoma, clinically presenting in the mediastinum, were diagnosed by examination of surgical pathologic specimens. These specimens were analyzed in the light of newer concepts regarding lymphoma, including current classification and clinical staging of these tumors. The influences of clinical and histopathologic features and therapeutic modalities were assessed in regard to prognosis. Fifty-seven patients had Hodgkin's disease and 61.3 percent of these patients survived five years, whereas 40 patients had lymphosarcomas and only 15 percent of these patients survived five years. Generally, mature lymphocytic predominance of lymphomas and nodularity, particularly in lymphosarcoma, were histopathologic features that were associated with increased survival. Nodular sclerosis was noted in 35 of the patients and mixed cellularity in 19, and these patients had favorable survival rates. Thirteen of the 15 patients with lymphoma of stage I survived five years. Five of the six patients with thymic Hodgkin's disease treated by surgical excision and roentgen therapy survived five years or more. Radical surgery has a distinct place in the therapy of selected patients with mediastinal lymphoma.