Malignant lymphoma, diffuse mixed small and large cell. A clinicopathologic study of 47 cases

Area of Science:

• Hematology
• Oncology
• Pathology

Background:

• Diffuse mixed lymphoma constitutes 6% of non-Hodgkin's lymphomas.
• This lymphoma type predominantly affects middle-aged and elderly patients, with a median age of 63.
• A female predominance is observed in diffuse mixed lymphoma cases.

Purpose of the Study:

• To describe the clinical and pathologic features of diffuse mixed lymphoma.
• To analyze treatment response and survival based on morphologic subtypes and treatment modalities.

Main Methods:

• Retrospective analysis of 47 cases of diffuse mixed lymphoma.
• Morphologic classification based on the proportion of small and large cells and nuclear features.
• Evaluation of treatment response and survival rates.

Main Results:

• Diffuse mixed lymphomas are characterized by roughly equal proportions of small and large cells (30-70%).
• Extranodal disease is common, often multifocal and concurrent with nodal involvement.
• No significant difference in outcomes was found between cases with <50% large cells versus >50% large cells, but immunoblastic variants showed the poorest response.
• Favorable response to cyclophosphamide, Adriamycin, vincristine, and prednisone (CHOP) chemotherapy was noted, with unfavorable responses to other treatments.

Conclusions:

• Diffuse mixed lymphoma exhibits diverse morphology and frequently presents with advanced-stage disease.
• CHOP chemotherapy appears to be an effective treatment for diffuse mixed lymphoma.
• Immunoblastic variants of diffuse mixed lymphoma warrant further investigation due to poor treatment response.