Mediastinal Grey Zone Lymphoma

Comments:
Mediastinal Grey-zone Lymphoma (MGZL): This is a category of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin lymphoma (cHL). They have overlapping clinical, morphologic, immunohistochemical, and molecular genetic features with primary mediastinal large B-cell lymphoma (PMLBCL), DLBCL, and cHL.

They occur in young patients (median age 33 years) but with a male predominance. Clinical presentation is similar to PMLBCL. Microscopic features are variable and the tumor cells range in appearance from centroblasts to lacunar-like, or Hodgkin-like cells. Background stroma is fibrotic with a sparse inflammatory infiltrate. Coagulative necrosis may be seen. Mediastinal grey-zone lymphomas are more aggressive than both PMLBCL and cHL with a worse prognosis.

Image courtesy of: Lucas R. Massoth, MD (@LucasMassoth); used with permission.