Case 102 – Update 3.

We now have further results for our 29 year old female who presented with an extensive left arm DVT and SOB. She was commenced on therapeutic LMWH. This thrombosis was provoked as she has been found to have a 11cm anterior mediastinal mass.

FBC, U+Es, calcium and phosphate: within normal range. LDH: 700.

CT CAP and PET CT confirms stage 2 disease.

Histology (core biopsy): Medium to large lymphoid cells with abundant cytoplasm.

Immunophenotype: CD20+, CD22+, CD79a+, sIg-, CD30 weak, CD15-.

Questions:

  1. What is the diagnosis?
  2. How would you manage this patient?

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