Mediastinal Lymphomas

Abstract

Malignant lymphoma, including non-Hodgkin’s lymphoma and Hodgkin’s disease, may involve any organ of the body. Mediastinal involvement may be part of a generalized process or may occur due to a malignant population limited to the mediastinum alone. Hodgkin’s disease has long been associated with mediastinal involvement and in recent years, the recognition of high-grade non-Hodgkin’s lymphoma limited to the mediastinum has become increasingly common, particularly in young women. Primary mediastinal lymphomas are relatively uncommon in adults, but in children, malignant lymphoma is among the most common of malignant mediastinal neoplasms. The majority of mediastinal lymphomas occur in the anterior or middle mediastinal components. The differential diagnosis of malignant processes in this location includes thymoma, germ cell tumors, and thyroid neoplasms. Lymphomas of the mediastinum usually arise in the lymph nodes, but rarely other tissues such as the thyroid gland may be the site of the primary disease. Mediastinal lymphomas have a wide spectrum of presentation ranging from an incidental finding on routine staging of lymphoma to a localized process associated with bulky adenopathy leading to life-threatening airway obstruction or pericardial tamponade.