Large-cell lymphoma with diffuse sclerosis

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Malignant lymphoma with diffuse sclerosis and bulky disease is a relatively rare tumor characterized by an aggressive mediastinal mass with superior vena cava obstruction. The tumor is resistant to radiation or chemotherapy, and the prognosis is poor. To better understand the nature of the proliferating cell in aggressive large-cell lymphoma with diffuse sclerosis, we used frozen-section immunohistologic techniques to study tissue from a 24-year-old man who died of the disease. Immunotyping demonstrated a B-cell neoplasm (T11—, Leu5—, B1+, Leul4+). B-cell-subset immunotyping disclosed an absence of markers expressed earlier in B-cell maturation (B2-, LN2-, J5-, I2-), but uniform expression of later, preplasma-cell, secretory blast-stage antigens (IgG+, kappa+, LN1+, PCA+). These immunohistologic observations may be helpful in interpreting biopsies of sclerosing lymphomas with mediastinal presentations.



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