The authors report a case of large-cell mediastinal lymphoma, a recently defined, fairly infrequent, highly aggressive tumor which responds scarcely to conventional chemotherapy. On the basis of its histopathology, the tumor must be classified as a highly malignant non-Hodgkin lymphoma. The latest data in the literature give cause for a little more optimism thanks to the introduction of the most recent schemes of chemotherapy combined with large-dose radiation for consolidation. Our patient was treated with chemotherapy CHOP high-dose radiation which resulted in complete disappearance of the mediastinal mass and rapid remission of the severe symptoms of mediastinal compression. After about 30 months, instrumental and laboratory findings confirm the persistence of the complete remission.

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