*For start of case see https://teamhaem.wordpress.com/2013/05/07/case-9-may-2013/  The rest of the updates are below*

The biopsy results from our patient with mediastinal mass have returned.  The histology is in keeping with primary mediastinal B cell lymphoma.

Hep B and C are negative.  Urate is normal.  A bone marrow aspirate and trephine biopsy have been performed which reveal no involvement by lymphoma.  A PET scan is requested and will be done within the next day or so.

There is a risk of SVCO and you want to start therapy within the next few days.  Allopurinol is started to prevent tumour lysis syndrome.

Questions:

• What treatments do you know of for primary mediastinal B cell lymphoma?
• What is your preferred treatment and why?

Please reply on Twitter and always include #teamhaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to  evolve over the coming week so keep checking #teamhaem for more information.

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