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Clinical Features: Primary Mediastinal Large B-cell Lymphoma (PMLBCL) Patients typically present with compressive symptoms from the large mediastinal mass, such as cough and shortness of breath. Esophageal compression may cause dysphagia. Rare patients are asymptomatic. Systemic symptoms, such as weight loss and fever, are seen in < 20% of cases.

About 25-30% of patients have superior vena cava (SVC) syndrome due to partial or complete obstruction of venous blood flow, either by direct compression or via infiltration of SVC wall. There is swelling of face and neck, upper extremity edema, chest discomfort, and dilated collateral veins on the chest. Pleural/pericardial effusion develops in 30-50% of cases. Most patients (80%) present with early disease (Stage I or II).

This photomicrograph shows sheets of medium to large sized tumor cells interrupted by areas of sclerosis.

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