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Primary Mediastinal Large B-Cell Lymphoma in a Child Presenting With Superior Mediastinal Syndrome and Chylous Pleural and Pericardial Effusion

Trivedi, Maharshi MD*; Chandar, Rumesh MD*; Nair, Manjusha DNB*; Jacob, Priya Mary MD; Thankamony, Priyakumari MD, PhD*

Journal of Pediatric Hematology/Oncology: April 03, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPH.0000000000001472
Clinical and Laboratory Observations: PDF Only

Primary mediastinal (thymic) large B-cell lymphoma is an aggressive B-cell lymphoma. It comprises <3% of all pediatric non-Hodgkin lymphomas (NHLs). Primary mediastinal (thymic) large B-cell lymphoma usually presents with serous pleural effusion, but presentation with chylous pleural and pericardial effusions is rare. We present a child who presented with features of a superior mediastinal syndrome. Biopsy of the mediastinal mass confirmed the diagnosis of large B-cell lymphoma. In view of nonimprovement of respiratory distress with chemotherapy and persistence of features of superior mediastinal syndrome, the child was evaluated and found to have massive pleural and pericardial effusion on imaging. Therapeutic thoracentesis and pericardiocentesis revealed chylous nature of the fluid.

Departments of *Pediatric Oncology

Pathology, Regional Cancer Centre, Trivandrum, Kerala, India

The authors declare no conflict of interest.

Reprints: Priyakumari Thankamony, MD, PhD, Department of Pediatric Oncology, Regional Cancer Centre, Trivandrum, Kerala 695011, India (e-mail:

Received October 31, 2018

Accepted February 21, 2019

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