Mediastinal grey-zone lymphoma: diagnostic and therapeutic challenges

This report presents a case of mediastinal grey zone lymphoma (GZL) in a young man, a rare subtype of B-cell lymphoma, unclassifiable, with intermediate features between diffuse large B-cell lymphoma and classic Hodgkin lymphoma (CHL). Being refractory to first-line treatment, a second biopsy revealed involvement by CHL, nodular sclerosis variant, requiring CHL-directed second-line therapy and autologous stem cell haematopoietic transplantation. This case highlights the diagnostic intricacies of GZL and the challenges in choosing optimal therapies, particularly in refractory/relapsing cases. It is important to recognise GZL as a distinct entity for accurate diagnosis and personalised treatment. This report contributes to raising awareness and enhancing understanding of this rare lymphoma.