Mediastinal Lymphoproliferative Disorders

Piña‐Oviedo, Sergio

doi:10.1097/pap.0000000000000305

Cited by 10 publications

(12 citation statements)

References 150 publications

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“…Thymic lymphoma is an extremely rare kind of tumor, and there is lack of large-scale studies or definite guidelines to describe its clinical characteristics, treatment, and prognosis ( 11 – 13 ). The pathologic types of thymic lymphoma mainly included PTLBL, NSCHL, DLBCL, and other sporadic types ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Incidence, mortality, and survival analyses of patients with thymic lymphoma

Wang

Huo

et al. 2022

Front. Oncol.

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ObjectivesTo explore the clinical and prognostic characteristics of thymic lymphoma and the effects of current treatments on the prognosis.MethodsPatients diagnosed as primary thymic lymphoma between 1975 and 2018 from the nine states of the US were identified, including Atlanta, Connecticut, Detroit, Hawaii, Iowa, New Mexico, San Francisco-Oakland, Seattle–Puget Sound, and Utah. Incidence and mortality rates were analyzed using SEER*Stat 8.3.9 software. Univariate and multivariate Cox regressions were performed to identify prognostic factors. The Kaplan–Meier curve and log-rank test were used to compare overall survival (OS) among different treatments.ResultsA total of 233 patients diagnosed as thymic lymphoma were identified, and eight of them were lost to follow-up or died upon diagnosis. The incidence of thymic lymphoma was 2.032 per ten million (95% CI: 1.777–2.312), and the mortality rate was 0.649 per ten million (95% CI: 0.508–0.817). Among the 225 patients with definite follow-up, 98 were males and 127 were females, with a median age of 33 years. The Cox regression results showed that age and pathological type were independent risk prognostic factors. The 5-, 10-, and 20-year OS were 80.0%, 77.5%, and 70.9%, respectively. For Ann Arbor stage I and II patients, there was no significant difference between the surgical group (N = 78) and the non-operative group (N = 65; P = 0.270). The radiotherapy group (N = 79) had better OS than the non-radiotherapy group (N = 64) in the first 25 years, and the prognosis in the later years was not significantly different (P = 0.051). The chemotherapy group (N = 37) had a significantly better prognosis than the non-chemotherapy group (N = 37; P = 0.020). Patients who received postoperative radiotherapy (N = 45) or who only received radiotherapy (N = 34) seemed to have better OS than that of patients who only received surgery (N = 33), although the difference was not significant (P = 0.063).ConclusionsAge and pathological type were independent prognostic factors for thymic lymphoma. Surgical treatment had limited effects on OS, while both radiotherapy and chemotherapy could significantly improve the survival outcome.

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Section: Discussionmentioning

confidence: 99%

Incidence, mortality, and survival analyses of patients with thymic lymphoma

Wang

Huo

et al. 2022

Front. Oncol.

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“…Through the evolution of morphology and immunohistochemistry, we have come to better understand this entity. In 2003, PMBCL became better understood, and through gene profiling and cytogenetics, it can be distinguished from DLBCL-not otherwise specified [26].…”

Section: Data Against Radiation Therapymentioning

confidence: 99%

Patients and Families’ Participation in Multidisciplinary Tumor Conferences Improves Patient and Family-Focused Cancer Care: Lessons Learned From a Debate on the Role of Radiation Therapy in Primary Mediastinal Non-Hodgkin Lymphoma

Ahmed¹,

Nittala²,

Kosalram³

et al. 2023

Cureus

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Incorporation of patients' preferences often leads to improved outcomes when included in the multidisciplinary tumor conference/board (MTC). However, patients' wishes are not included or considered in the MTC decision-making. We need better strategies and approaches for patient-inclusive, shared decision-making. When finding ourselves at a crossroads regarding the next step in a patient's treatment, we saw a unique opportunity for an MTC with the patient and her husband in attendance. The results of a full literature review regarding the role of consolidative radiation therapy (RT) in a patient with primary (thymic) B-cell lymphoma after completion of chemotherapy and fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) scan with a Deauville score of 4 were presented in a creative, engaging debate-style forum with visual aids. The patient and her husband were able to follow the discussion and, in the end, a consensus recommendation, heavily focused on the patient's preferences, was offered and adopted, which ultimately resulted in the avoidance of excess treatment and likely improved her long-term quality of life outcome. These collaborative and innovative interactions benefit not only our patients but enrich our lives too as healthcare providers and strengthen us as a cancer care team in terms of understanding diversity in decision-making processes.

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“…Primary mediastinal lymphoproliferative malignancies are rare, accounting for less than 5% of all mediastinal malignancies. [ 1 ] Primary mediastinal MALT lymphomas are very rare.…”

Section: Introductionmentioning

confidence: 99%

Coexistence of primary mediastinal MALT lymphoma and multiple myeloma like POEMS syndrome: A case report and literature review

et al. 2023

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Rationale: The coexistence of the extranidal marginal zone lymphoma (MZL) of mucosa–associated lymphoid tissue (MALT) and multiple myeloma (MM) is an exceedingly rare situation. The rare situation precludes any evidence-based guidelines for MZL or MM. Patient concerns and diagnoses: We presented a unique case of the coexistence of primary mediastinal MALT lymphoma and MM like polyneuropathy, organomegaly, endocrinopathy, M-protein, skin syndrome. Interventions and outcomes: The patient was first diagnosed with polyneuropathy, organomegaly, endocrinopathy, M-protein, skin syndrome in the department of neurology, then MM in the department of hematology, and the mediastinal MALT simultaneously coexisting with MM was found by biopsy in the department of thoracic surgery. The patient received combination therapy with rituximab and bortezomib followed by lenalidomide maintenance. To understand MZL lymphoma with plasmacytic differentiation better, we analyzed cases of MZL lymphomas with plasma cell neoplasms. Most of these cases were MZL lymphomas with light chain-restricted plasmacytic differentiation. The lymphomas relapsed with plasma cell neoplasms or transformed into plasma cell neoplasms after anti-lymphoma therapy. Lessons: The case demonstrated clinical complexity and the importance of the detailed assessment. The case and literature review demonstrated the value of detecting light chain-restricted plasmacytic differentiation for the treatment of MZL lymphoma with rituximab plus lenalidomide or bortezomib.

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Mediastinal Lymphoproliferative Disorders

Cited by 10 publications

References 150 publications

Incidence, mortality, and survival analyses of patients with thymic lymphoma

Incidence, mortality, and survival analyses of patients with thymic lymphoma

Patients and Families’ Participation in Multidisciplinary Tumor Conferences Improves Patient and Family-Focused Cancer Care: Lessons Learned From a Debate on the Role of Radiation Therapy in Primary Mediastinal Non-Hodgkin Lymphoma

Coexistence of primary mediastinal MALT lymphoma and multiple myeloma like POEMS syndrome: A case report and literature review

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