Primary Mediastinal (Thymic) Large B-Cell Lymphoma
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DIS-PMBCL |
|---|---|
| Type | Disease |
| Aliases | Mediastinal LBCLPMBCLPMLBCLPrimary Mediastinal Large B-Cell LymphomaПервинна медіастинальна (тимічна) B-великоклітинна лімфома |
| Status | reviewed 2026-04-25 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-BCELL-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 9679/3 |
|---|---|
| icd_10 | C85.2 |
| who_classification | Aggressive B-cell lymphomas — Primary mediastinal (thymic) large B-cell lymphoma per WHO 5th ed. |
Notes
STUB — pending Clinical Co-Lead approval per CHARTER §6.1. CT chest з biopsy of mediastinal mass — initial workup. Avoid steroids перед biopsy if possible. CNS prophylaxis not routine. Differential — anterior/superior mediastinal mass: sarcoidosis (D86.0–D86.2) can present identically to PMBCL on CT (bulky mediastinal mass, bilateral hilar nodes, pleural/pericardial effusions). PET/CT uptake indistinguishable. Biopsy essential; sarcoid granulomata (non-caseating, CD15−/CD30−, no malignant large B-cells) exclude PMBCL. ACE, serum calcium, BAL cell differential help pre-biopsy. Do not start R-CHOP / DA-EPOCH-R on imaging alone.
Used By
Algorithms
ALGO-PMBCL-1L- ALGO-PMBCL-1LALGO-PMBCL-2L- ALGO-PMBCL-2L
Disease
DIS-DLBCL-NOS- Diffuse Large B-Cell Lymphoma, NOS
Indication
IND-PMBCL-1L-DA-EPOCH-R- IND-PMBCL-1L-DA-EPOCH-RIND-PMBCL-1L-RCHOP-RT- IND-PMBCL-1L-RCHOP-RTIND-PMBCL-2L-RICE-AUTOSCT- IND-PMBCL-2L-RICE-AUTOSCT
Questionnaires
QUEST-PMBCL-1L-STUB- Primary Mediastinal Large B-Cell Lymphoma — first line
Red flag
RF-ACTIVE-AUTOIMMUNE-DISEASE-ICI-RISK- Patient with active or incompletely controlled pre-existing autoimmune or inflammatory di...RF-PMBCL-FRAILTY-AGE- Frailty (ECOG ≥3 OR age ≥75 + ≥2 comorbidities) — DA-EPOCH-R infusional toxicity poorly t...RF-PMBCL-HIGH-RISK-BIOLOGY- Bulky mediastinal disease (>10 cm) and/or aaIPI ≥2 — favors DA-EPOCH-R over R-CHOP+RT per...RF-PMBCL-INFECTION-SCREENING- Pre-treatment HBV/HCV/HIV serology mandatory before rituximab; HBsAg+ requires antiviral...RF-PMBCL-MEDIASTINAL-AIRWAY- PMBCL with bulky anterior mediastinal mass (≥10 cm) causing airway compromise (stridor, o...RF-PMBCL-ORGAN-DYSFUNCTION- Cardiac dysfunction (LVEF <50%) at baseline — both PMBCL 1L arms contain doxorubicin; car...RF-PMBCL-SVC-SYNDROME- Primary mediastinal B-cell lymphoma with superior vena cava (SVC) syndrome: facial/upper-...RF-PMBCL-TRANSFORMATION-PROGRESSION- Mid-treatment PET-CT progression (Deauville 4-5 with new lesions or SUVmax increase >25%)...
Sources
SRC-ESMO-DLBCL-2024- ESMO Clinical Practice Guideline on Diffuse Large B-Cell LymphomaSRC-ESMO-LYMPHOMA-2025- Lymphomas: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up