Primary Central Nervous System Lymphoma

Gerstner, Elizabeth R.; Batchelor, Tracy T.

doi:10.1001/archneurol.2010.3

Cited by 223 publications

(183 citation statements)

References 190 publications

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“…The mean number of lesions was approximately 2 per patient, which is similar to the numbers cited in a previous study [13] . The literature indicates that more than half of patients have only a single lesion [1,9,14,15] , as was the case in our study, although a high rate of multiple lesions was found in immunodeficient patients in previous studies [4,9,[16][17][18] . In striking contrast, our group of immunocompromised patients had an even greater chance of having a single lesion than the immunocompetent patients, a finding that could help us in differentiating PCNLS from toxoplasmosis in immunodeficient patients (particularly for HIV-positive patients), which is usually multifocal [19] .…”

Section: Discussionsupporting

confidence: 47%

“…These symptoms were similar to those described by others [7] . Seizures were less commonly observed than with other types of brain tumors, probably because PCNSL involves predominantly subcortical white matter and deep locations rather than epileptogenic gray matter [1] .…”

Section: Discussionmentioning

confidence: 85%

“…diffuse large B-cell lymphomas in the majority of cases [1] , constituting approximately 3%-5% of all malignant tumors of the central nervous system (CNS), 1% of non-Hodgkin's lymphomas in immunocompetent patients and up to 17%-42% of all acquired immunodeficiency syndrome (AIDS)-related lymphomas [2] . The incidence of PCNSL in Western countries is five per one million person-years [3] .…”

mentioning

confidence: 99%

“…The incidence of PCNSL in Western countries is five per one million person-years [3] . After a continual increase over the past two decades, epidemiologic data suggest a recent stabilization or decrease in the incidence of PCNSL [1] , particularly among young patients suffering from AIDS, probably associated with the development of new active antiviral drugs. In contrast, the incidence of PCNSL remains high among older adults who are mostly immunocompetent [4] , in patients with inherited immunodeficiencies and in those with an acquired immunodeficiency, such as transplantation and oncology patients [2] .…”

mentioning

confidence: 99%

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Findings at presentation in primary CNS diffuse large B-cell lymphoma of the brain: A comparison of immunocompetent and immunodeficient patients

Sampedro

Corroto²,

Arias³

et al. 2013

JBGC

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Background/Objectives: Primary central nervous system lymphoma (PCNSL) is a rare tumour with poor prognosis. Due to the increased number of patients with PCNSL over the past two decades our purpose are to describe magnetic resonance imaging (MRI) and Computed Tomography (CT) findings in (PCNSL) of the brain, and to study the differences between immunocompetent and immunodeficient patients with PCNSL. Methods:A retrospective, descriptive study was performed with 59 patients diagnosed of PCNSL in two hospitals from 1997 to 2010. Immunocompetent (n=38) and immunodeficient (n=21) patients were compared and differences between both groups were analyzed. Patients were evaluated according to sex, age, median time from clinical symptoms presentation to pathologic diagnosis, clinical symptoms, location, number of lesions, size, MRI and CT characteristics. Significance was defined as p < 0.05.Results: MRI findings: 50% of lesions in immunocompetent and 52.4% in immunodeficient group were heterogeneous, 89.5% of lesions in immunocompetent and 85,7% in immunodeficient were hypo-isointense on T1WI; 63.2% of lesions in immunocompetent and 76.2% in immunodeficient group were hyperintense on T2WI. CT images: 48.39% of lesions in immunocompetent and 20% in immunodeficient group were hyperdense. Statistically significant differences between immunocompetent and immunodeficient patients were found when evaluating the age (p < 0.000) and median time from clinical symptoms presentation to pathologic diagnosis (p < 0.008).Conclusions: MRI and CT are able to define imaging characteristics of PCNSL, promoting a quick diagnosis. There are no significant differences between immunocompetent and immunodeficient patients for MR and CT features.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 85%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Findings at presentation in primary CNS diffuse large B-cell lymphoma of the brain: A comparison of immunocompetent and immunodeficient patients

Sampedro

Corroto²,

Arias³

et al. 2013

JBGC

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“…The incidence of intramedullary lymphoma is exceedingly rare (6,7,9). Furthermore, isolated spinal cord involvement is uncommon and observed in <1% of cases of PCNSL (3). As the MRI findings of primary intramedullary spinal cord lymphoma (PISCL) mimic those of other causes of myelopathy, including demyelinating disease, Flanagan et al described the characteristic MRI features of PISCL as follows: 1) multifocal, 2) persistent gadolinium-enhancement and 3) cauda equina or conus medullaris involvement (7).…”

Section: Discussionmentioning

confidence: 99%

Lymphomatosis Cerebri with Intramedullary Spinal Cord Involvement

et al. 2013

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Lymphomatosis cerebri (LC) is a rare form of primary central nervous system lymphoma (PCNSL). Little is known about cases of LC with spinal cord involvement. Among the 11 PCNSL patients treated in our hospital during a four-year period, we identified two cases of LC with spinal cord lesions. One showed a spinal cord lesion followed by leukoencephalopathy. The other showed a spinal cord lesion after LC. In both cases, the histopathology was diffuse large B-cell lymphoma. It is possible that LC may affect the entire central nerve system, and tumor infiltration to the brain and spinal cord in LC may occur more frequently than has been previously considered.

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Progressive Leg Pain and Weakness

Navalkele¹,

Georgescu²,

Burns³

et al. 2013

JAMA Neurol

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54-year-old man presented with progressive asymmetric leg pain and weakness. He had a history of invasive squamous cell carcinoma that was fully treated 2 years earlier. His leg symptoms progressed relentlessly during several months. Imaging studies demonstrated enhancement of the cauda equina and leptomeninges of the lower spinal cord. Initial cerebrospinal fluid examination showed an elevated protein concentration and lymphocytic pleocytosis with no malignant cells on cytological analysis. There was short-term improvement in symptoms and cerebrospinal fluid abnormalities with intravenous steroids. Two additional cerebrospinal fluid studies showed normal cytological findings, elevated IgG synthesis, and elevated antibody titers to varicella-zoster virus. Over time, the patient worsened, developed cranial neuropathies, and ultimately died. The pathological diagnosis and the approach to the clinical data are discussed.

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Primary Central Nervous System Lymphoma

Cited by 223 publications

References 190 publications

Findings at presentation in primary CNS diffuse large B-cell lymphoma of the brain: A comparison of immunocompetent and immunodeficient patients

Findings at presentation in primary CNS diffuse large B-cell lymphoma of the brain: A comparison of immunocompetent and immunodeficient patients

Lymphomatosis Cerebri with Intramedullary Spinal Cord Involvement

Progressive Leg Pain and Weakness

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