Primary central nervous system lymphoma.

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

Primary central nervous system lymphoma.

Brain Pathol. 1992 Apr;2(2):97-109. Unique Identifier : AIDSLINE MED/94093823
Grant JW; Isaacson PG; Department of Histopathology, Addenbrooke's Hospital, Cambridge,; U.K.

Abstract: Primary central nervous system lymphomas (PCNSL) are uncommon neoplasms accounting for less than 2% of brain tumours. Their incidence appears to be increasing across a wide age range, in both immunocompetent and immunosuppressed populations. Particular risk groups include those with congenital and acquired immunodeficiencies and transplant recipients. The spread of the AIDS epidemic has seen large numbers of complicating PCNSL develop. Epstein-Barr virus infection appears to play a role in the development of these lymphomas in the immunosuppressed population. The aetiology of these tumours in the immunocompetent is uncertain. Their tendency to remain within the nervous system is not well understood but may be a function of CNS binding molecules carried by lymphocytes. Clinically PCNSL may present with a wide variety of signs and symptoms and has a capacity to mimic many other neurological conditions. Radiologically they appear as hyperdense homogenous deposits in subcortical white matter. Although most lesions are intermediate or high grade B cell lymphomas, T cell lymphomas are being recognised with increasing frequency. Immunohistochemistry and genotypic analysis have an important role in accurately characterising PCNSL, particularly in stereotactic biopsies. Involvement of multiple areas of the neuraxis, the eye and multiple intracranial sites can occur in the absence of obvious systemic lymphoma. The role of surgery in their treatment is uncertain. A combination of radiotherapy and chemotherapy can increase the length of survival. The prognosis, however, remains poor in comparison with nodal lymphomas, and particularly so in those with AIDS.

Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS Brain Neoplasms/DIAGNOSIS/EPIDEMIOLOGY/*PATHOLOGY/THERAPY Central Nervous System Neoplasms/DIAGNOSIS/EPIDEMIOLOGY/ *PATHOLOGY/THERAPY Human HIV Infections/COMPLICATIONS Lymphoma/DIAGNOSIS/EPIDEMIOLOGY/*PATHOLOGY/THERAPY JOURNAL ARTICLE REVIEW REVIEW, ACADEMIC
940430
M9440895

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