Which clinical history findings are characteristic of primary mediastinal B-cell lymphoma (PMBCL)?

Updated: Sep 14, 2019
  • Author: Sonali M Smith, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Primary mediastinal B-cell lymphoma (PMBCL) patients usually present with a bulky anterior mediastinal mass in their third or fourth decade in life. Superior vena cava (SVC) syndrome is common, and, in some reports, 50-80% of patients can have some form of SVC compromise. Phrenic nerve palsy, dysphagia, hoarseness, and breast swelling (in women) can occur. Shortness of breath can be due to pleural effusion, massive mediastinal mass, pericardial effusion, or airway compression. Systemic symptoms (fever, weight loss, night sweats) occur in 30-47% of patients.

Most patients have localized symptoms that depend on the bulk and extent of the disease; however, if recurrence develops, a hematogenous pattern of spread to parenchymal organs, such as the liver, kidneys, or brain, is common. Symptoms in recurrent disease accordingly vary and depend on the organ involved.


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