Bulky lymphoma disease: single nodal mass >=7 cm OR mediastinal mass >1/3 thoracic diamet...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-BULKY-DISEASE`
Type	Red flag
Status	reviewed 2026-04-24 \| pending_clinical_signoff
Diseases	`DIS-HCV-MZL`
Sources	`SRC-ESMO-MZL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Bulky lymphoma disease: single nodal mass >=7 cm OR mediastinal mass >1/3 thoracic diameter OR significant symptomatic burden
Clinical direction	intensify
Category	high-risk-biology
Shifts algorithm	ALGO-HCV-MZL-1L

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "dominant_nodal_mass_cm",
      "threshold": 7.0
    },
    {
      "comparator": ">",
      "finding": "mediastinal_ratio",
      "threshold": 0.33
    },
    {
      "finding": "symptomatic_b_symptoms_severe",
      "value": true
    }
  ],
  "type": "imaging_finding"
}

Notes

Standard bulky-disease definition adapted from B-cell lymphoma guidelines.

Used By

Algorithms

ALGO-HCV-MZL-1L - ALGO-HCV-MZL-1L

Indications

IND-HCV-MZL-1L-ANTIVIRAL - IND-HCV-MZL-1L-ANTIVIRAL

Questionnaires

QUEST-HCV-MZL-1L - HCV-associated Marginal Zone Lymphoma — first line