What is your approach for bulky stage I primary mediastinal B-cell lymphoma in a patient with a positive post-chemotherapy PET-CT (residual mass and Deauville 5)?

Interpreting end-of-treatment PET in PMBL can be tricky. False positives here are very common! Fake-outs include thymic rebound masquerading as refractory disease; avidity at rim (which is almost always biopsy-neg); or residual avidity throughout residual mass which again can be biopsy negative. I w...

This is a complex situation without a lot of data to guide us. While I agree mostly with Dr. Matasar, I have some additional comments:

1) Did the pt respond clinically to chemo? If yes, and PET is still positive, that is better then no clinical response

2) Assuming a clinical response and a PET assess...