Long-term survival cases of primary mediastinal malignant lymphoma (diffuse large B-cell lymphoma with sclerosis) after preoperative chemoradiotherapy. Report of two cases.

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Two cases in which long-term survival was achieved by multidisciplinary treatment for primary mediastinal malignant lymphoma are described. In both patients, chest X-rays showed an abnormal shadow, and CT scans showed a giant tumor in the anterior mediastinum. A needle biopsy performed after admission led to a diagnosis of diffuse large B-cell lymphoma with sclerosis. Both patients were treated with chemotherapy mainly consisting of CHOP, followed by 50 Gy (Co<SUP>60</SUP>) irradiation, which resulted in marked tumor regression. Surgery of the residual tumor was performed with the intent of deciding the subsequent therapeutic strategy. In both cases, the tumor was completely removed. Postoperative histopathological examination revealed no evidence of viable tumor cells within the residual tumor, revealing a pathological complete response. The patients are alive with no evidence of tumor recurrence as of 8 and 4 years after surgery. Finally, rare primary mediastinal diffuse large B-cell lymphoma with sclerosis, as seen in our patients, should be accurately diagnosed histologically, and treated by chemoradiotherapy, followed by removal of the residual tumor as soon as it responds to the chemoradiotherapy.
特定非営利活動法人日本呼吸器外科学会の論文