Mediastinal lymphomas ? A clinicopathologic study

Background: Mediastinal lymphomas are relatively uncommon lesions that sometimes pose an interesting diagnostic and therapeutic problem for the clinician. A multifaceted approach to both disease definition and diagnosis, as proposed by the Revised European and American Lymphoma (REAL) classification and updated in the WHO classification is now considered the state of the art. Objective: To classify and evaluate the histomorphology of mediastinal lymphomas and correlate the clinical findings with radiological, immunohistologic and other laboratory parameters. Method: A 5 year study was done in Dept. of Pathology, of a private Medical College on mediastinal lesions. Total number of cases studied was 66, with lymphomas making up 8 cases. Histopathology sections taken were stained with routine Hematoxylin and Eosin stains. Immunohistochemistry was done as required. Results: The age range of patients with mediastinal lymphomas were 12 to 80 years with a mean of 41 years. All non-Hodgkin’s lymphomas (NHL) were NHL-B cell type and were in the older age group. Three out of the four cases of Hodgkin lymphoma (HL) were mixed cellularity type and the fourth was nodular sclerosing type. The HLs were seen in a younger age group. Immunohistochemistry was done in all cases to confirm the diagnosis. Conclusion: Mediastinal lymphomas are rare & interesting neoplasms, usually located in all compartments of mediastinum. A histomorphological analysis aided by immunohistochemistry and radiology permits an exact diagnosis in many cases.