Mediastinal large B cell lymphoma and surrounding gray areas: a report of the lymphoma workshop of the 20th meeting of the European Association for Haematopathology

Virchows Arch. 2023 Dec;483(6):733-749. doi: 10.1007/s00428-023-03550-5. Epub 2023 Aug 2.

Abstract

Session 3 of the 2021 European Association for Haematopathology/Society for Hematopathology Workshop focused on mediastinal large B cell lymphomas and surrounding gray areas. One half of the session was dedicated to primary mediastinal large B cell lymphoma (PMBL) and included cases with classic clinicopathologic features, as well as cases with either morphologic or immunophenotypic variation, and PMBL-like cases with primary extramediastinal disease. The role of additional immunophenotyping and/or molecular testing to aid in the diagnosis of PMBL was discussed. The second half of the session focused on mediastinal and non-mediastinal gray zone lymphomas (GZL) with features intermediate between diffuse large B cell lymphoma (DLBCL) and classic Hodgkin lymphoma (CHL). Several cases illustrating the current challenges in separating this entity from PMBL/DLBCL and CHL were presented. There was discussion regarding the clinical and genetic differences between mediastinal and non-mediastinal GZLs. Rare cases of PMBL and GZL associated with EBV or follicular lymphoma were reviewed. Finally, several cases included in the session highlighted composite or sequential CHL and PMBL/DLBCL and/or GZL, highlighting challenges in separating such cases from GZL.

Keywords: B cell lymphoma, Unclassifiable, with features intermediate between diffuse large B cell lymphoma and classic Hodgkin lymphoma; Classic Hodgkin lymphoma; Composite lymphoma; Gray zone lymphoma; Mediastinal gray zone lymphoma; Primary mediastinal large B cell lymphoma.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor
  • Hodgkin Disease* / diagnosis
  • Hodgkin Disease* / pathology
  • Humans
  • Lymphoma, Follicular*
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Mediastinal Neoplasms* / diagnosis
  • Mediastinal Neoplasms* / pathology

Substances

  • Biomarkers, Tumor