Massive primary B–cell mediastinal lymphoma with vascular and pulmonary hilum involvement requiring multidisciplinary approach: a case report

Primary mediastinal large B-cell lymphoma (PMBL) is a distinct clinicopathologic entity that typically presents as an anterior mediastinal mass in young adults. Although systemic immunochemotherapy is the cornerstone of treatment, massive tumors may occasionally cause life-threatening cardiopulmonary compromise and diagnostic uncertainty. We report the case of a 30-year-old man who presented with superior vena cava syndrome due to a giant mediastinal mass. Because of imminent cardiopulmonary risk and the inability to obtain a definitive diagnosis using minimally invasive techniques, surgical debulking was performed. Histopathological and immunohistochemical evaluation established the diagnosis of PMBL.