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2020, Número 4

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Rev Hematol Mex 2020; 21 (4)


Linfoma mediastinal primario de células grandes B

Soriano-Lorenzo J, Zaldívar-Blanco K

Idioma: Español
Referencias bibliográficas: 40
Paginas: 225-235
Archivo PDF: 358.74 Kb.


RESUMEN

El linfoma mediastinal primario de células grandes B es una variedad de linfoma no Hodgkin, de localización mediastínica, con rápido crecimiento y agresividad local. Constituye 3% de los linfomas no Hodgkin y 4.7% de los linfomas del mediastino. Este linfoma afecta mayormente a mujeres jóvenes, sobre todo entre la tercera y cuarta décadas de la vida. Se manifiesta como una masa de crecimiento rápido en el mediastino anterior, durante su evolución infiltra estructuras adyacentes. Su diagnóstico es anatomopatológico, se requiere tomar biopsia de la masa tumoral y realizar estudios histopatológicos, inmunohistoquímicos y genéticos. El manejo terapéutico inicial es de gran importancia, porque los resultados de segundas líneas de tratamiento contra la enfermedad progresiva/recidivante son menos eficaces. En la actualidad diferentes esquemas de inmunoquimioterapia muestran diversos resultados de efectividad, la administración de uno u otro estará determinada por las características propias del paciente y la valoración que realice el médico de asistencia. La recaída luego de una terapia exitosa es baja. En estos casos, las opciones terapéuticas incluyen la reinducción de quimioterapia con agentes de resistencia no cruzada, seguida de trasplante de células madre, radioterapia y recientemente se aprobó el pembrolizumab para estos casos.


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