Primary mediastinal large B-cell lymphoma differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
Primary mediastinal large B-cell lymphoma must be differentiated from other diseases that cause | Primary mediastinal large B-cell lymphoma must be differentiated from other diseases that cause [[swollen face]], [[superior vena cava syndrome]], and [[fever]], [[night sweats]] and [[weight loss]] such as [[hodgkin's lymphoma]], [[thymoma]], and other [[Non-Hodgkin lymphoma|non hodgkin's lymphomas]]. | ||
==Differentiating [Disease name] from other Diseases== | ==Differentiating [Disease name] from other Diseases== | ||
Primary mediastinal large B-cell lymphoma must be differentiated from other diseases that cause | * Primary mediastinal large B-cell lymphoma must be differentiated from other diseases that cause [[swollen face]], [[superior vena cava syndrome]], and [[fever]], [[night sweats]] and [[weight loss]] such as [[hodgkin's lymphoma]], [[thymoma]], and other [[Non-Hodgkin lymphoma|non hodgkin's lymphomas]]. | ||
* The differentiation is determined on the basis of [[biopsy]] findings and immunophenotype, which are as follows: | |||
* [[Thymoma]] | * [[Thymoma]] | ||
** Thymic epithelial cells stain for epithelial markers such as keratin and epithelial membrane antigen.<ref name="pmid2420219">{{cite journal |vauthors=Kodama T, Watanabe S, Sato Y, Shimosato Y, Miyazawa N |title=An immunohistochemical study of thymic epithelial tumors. I. Epithelial component |journal=Am. J. Surg. Pathol. |volume=10 |issue=1 |pages=26–33 |date=January 1986 |pmid=2420219 |doi= |url=}}</ref> | ** Thymic [[epithelial cells]] stain for epithelial markers such as [[keratin]] and epithelial membrane antigen.<ref name="pmid2420219">{{cite journal |vauthors=Kodama T, Watanabe S, Sato Y, Shimosato Y, Miyazawa N |title=An immunohistochemical study of thymic epithelial tumors. I. Epithelial component |journal=Am. J. Surg. Pathol. |volume=10 |issue=1 |pages=26–33 |date=January 1986 |pmid=2420219 |doi= |url=}}</ref> | ||
* [[Hodgkin's lymphoma]]<ref name="pmid9327746">{{cite journal |vauthors=von Wasielewski R, Mengel M, Fischer R, Hansmann ML, Hübner K, Franklin J, Tesch H, Paulus U, Werner M, Diehl V, Georgii A |title=Classical Hodgkin's disease. Clinical impact of the immunophenotype |journal=Am. J. Pathol. |volume=151 |issue=4 |pages=1123–30 |date=October 1997 |pmid=9327746 |pmc=1858022 |doi= |url=}}</ref> | * [[Hodgkin's lymphoma]]<ref name="pmid9327746">{{cite journal |vauthors=von Wasielewski R, Mengel M, Fischer R, Hansmann ML, Hübner K, Franklin J, Tesch H, Paulus U, Werner M, Diehl V, Georgii A |title=Classical Hodgkin's disease. Clinical impact of the immunophenotype |journal=Am. J. Pathol. |volume=151 |issue=4 |pages=1123–30 |date=October 1997 |pmid=9327746 |pmc=1858022 |doi= |url=}}</ref> | ||
** Reed-Sternberg cells typically express CD15 and CD30 | ** Reed-Sternberg cells typically express [[CD15]] and [[CD30]] | ||
* [[Thymic carcinoma]] | * [[Thymic carcinoma]] | ||
** The lymphocytes have phenotype of mature T cells (CD1a-, CD3+, and CD4+ or CD8+.<ref name="pmid1991250">{{cite journal |vauthors=Suster S, Rosai J |title=Thymic carcinoma. A clinicopathologic study of 60 cases |journal=Cancer |volume=67 |issue=4 |pages=1025–32 |date=February 1991 |pmid=1991250 |doi= |url=}}</ref> | ** The [[lymphocytes]] have phenotype of mature [[T cell|T cells]] ([[CD1a]]-, [[CD3|CD3+]], and [[CD4+ cell|CD4]]+ or [[CD8+ T cells|CD8+]].<ref name="pmid1991250">{{cite journal |vauthors=Suster S, Rosai J |title=Thymic carcinoma. A clinicopathologic study of 60 cases |journal=Cancer |volume=67 |issue=4 |pages=1025–32 |date=February 1991 |pmid=1991250 |doi= |url=}}</ref> | ||
* [[Acute myeloid Leukemia]] | * [[Acute myeloid leukemia|Acute myeloid Leukemia]] | ||
** [[Myeloblasts]] immature cells with large nuclei, prominent [[nucleoli]], and a variable amount of pale blue [[cytoplasm]] with [[auer rods]]<ref name="pmid27069254">{{cite journal |vauthors=Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, Bloomfield CD, Cazzola M, Vardiman JW |title=The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia |journal=Blood |volume=127 |issue=20 |pages=2391–405 |date=May 2016 |pmid=27069254 |doi=10.1182/blood-2016-03-643544 |url=}}</ref> | ** [[Myeloblasts]] immature cells with large [[nuclei]], prominent [[nucleoli]], and a variable amount of pale blue [[cytoplasm]] with [[auer rods]]<ref name="pmid27069254">{{cite journal |vauthors=Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, Bloomfield CD, Cazzola M, Vardiman JW |title=The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia |journal=Blood |volume=127 |issue=20 |pages=2391–405 |date=May 2016 |pmid=27069254 |doi=10.1182/blood-2016-03-643544 |url=}}</ref> | ||
* [[Diffuse large B-cell lymphoma]] | * [[Diffuse large B-cell lymphoma]] | ||
** Involvement of bone marrow or distant lymph nodes is indicative of systemic DLBCL with secondary mediastinal involvement | ** Involvement of [[bone marrow]] or distant lymph nodes is indicative of systemic [[DLBCL]] with secondary [[mediastinal]] involvement. | ||
* [[Mediastinal germ cell tumor]]<ref name="pmid11078494">{{cite journal |vauthors=Mann JR, Raafat F, Robinson K, Imeson J, Gornall P, Sokal M, Gray E, McKeever P, Hale J, Bailey S, Oakhill A |title=The United Kingdom Children's Cancer Study Group's second germ cell tumor study: carboplatin, etoposide, and bleomycin are effective treatment for children with malignant extracranial germ cell tumors, with acceptable toxicity |journal=J. Clin. Oncol. |volume=18 |issue=22 |pages=3809–18 |date=November 2000 |pmid=11078494 |doi=10.1200/JCO.2000.18.22.3809 |url=}}</ref> | * [[Mediastinal germ cell tumor]]<ref name="pmid11078494">{{cite journal |vauthors=Mann JR, Raafat F, Robinson K, Imeson J, Gornall P, Sokal M, Gray E, McKeever P, Hale J, Bailey S, Oakhill A |title=The United Kingdom Children's Cancer Study Group's second germ cell tumor study: carboplatin, etoposide, and bleomycin are effective treatment for children with malignant extracranial germ cell tumors, with acceptable toxicity |journal=J. Clin. Oncol. |volume=18 |issue=22 |pages=3809–18 |date=November 2000 |pmid=11078494 |doi=10.1200/JCO.2000.18.22.3809 |url=}}</ref> | ||
** Germ cell tumor markers such as beta-human chorionic gonadotropin [hCG] and alpha fetoprotein are positive | ** [[Germ cell tumor]] markers such as [[Human chorionic gonadotropin|beta-human chorionic gonadotropin]] [<nowiki/>[[hCG]]] and [[Alpha-fetoprotein|alpha fetoprotein]] are positive. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 22:50, 2 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Badria Munir M.B.B.S.[2]
Overview
Primary mediastinal large B-cell lymphoma must be differentiated from other diseases that cause swollen face, superior vena cava syndrome, and fever, night sweats and weight loss such as hodgkin's lymphoma, thymoma, and other non hodgkin's lymphomas.
Differentiating [Disease name] from other Diseases
- Primary mediastinal large B-cell lymphoma must be differentiated from other diseases that cause swollen face, superior vena cava syndrome, and fever, night sweats and weight loss such as hodgkin's lymphoma, thymoma, and other non hodgkin's lymphomas.
- The differentiation is determined on the basis of biopsy findings and immunophenotype, which are as follows:
- Thymoma
- Thymic epithelial cells stain for epithelial markers such as keratin and epithelial membrane antigen.[1]
- Hodgkin's lymphoma[2]
- Thymic carcinoma
- Acute myeloid Leukemia
- Diffuse large B-cell lymphoma
- Involvement of bone marrow or distant lymph nodes is indicative of systemic DLBCL with secondary mediastinal involvement.
- Mediastinal germ cell tumor[5]
- Germ cell tumor markers such as beta-human chorionic gonadotropin [hCG] and alpha fetoprotein are positive.
References
- ↑ Kodama T, Watanabe S, Sato Y, Shimosato Y, Miyazawa N (January 1986). "An immunohistochemical study of thymic epithelial tumors. I. Epithelial component". Am. J. Surg. Pathol. 10 (1): 26–33. PMID 2420219.
- ↑ von Wasielewski R, Mengel M, Fischer R, Hansmann ML, Hübner K, Franklin J, Tesch H, Paulus U, Werner M, Diehl V, Georgii A (October 1997). "Classical Hodgkin's disease. Clinical impact of the immunophenotype". Am. J. Pathol. 151 (4): 1123–30. PMC 1858022. PMID 9327746.
- ↑ Suster S, Rosai J (February 1991). "Thymic carcinoma. A clinicopathologic study of 60 cases". Cancer. 67 (4): 1025–32. PMID 1991250.
- ↑ Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, Bloomfield CD, Cazzola M, Vardiman JW (May 2016). "The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia". Blood. 127 (20): 2391–405. doi:10.1182/blood-2016-03-643544. PMID 27069254.
- ↑ Mann JR, Raafat F, Robinson K, Imeson J, Gornall P, Sokal M, Gray E, McKeever P, Hale J, Bailey S, Oakhill A (November 2000). "The United Kingdom Children's Cancer Study Group's second germ cell tumor study: carboplatin, etoposide, and bleomycin are effective treatment for children with malignant extracranial germ cell tumors, with acceptable toxicity". J. Clin. Oncol. 18 (22): 3809–18. doi:10.1200/JCO.2000.18.22.3809. PMID 11078494.