Radiation-Induced Primary Brain Lymphoma: A Case Report

Abstract

A patient who developed primary brain lymphoma 6 years following whole brain irradiation due to a low-grade glioma is described. The patient had no evidence of congenital or acquired immunodeficiency state and achieved a good and prompt response to aggressive chemotherapy, including high-dose methotrexate. The previous radiation therapy is implicated in the etiology of the lymphoma because of the geometric coincidence, the relatively long latency period and the different histology. A brief review of current literature is reported.

Synchronous meningioma and anaplastic large cell lymphoma

“…Ionizing radiation is known to induce brain neoplasms unequivocally, with the most frequent being meningiomas, sarcomas and gliomas 26,28 . Yet, radiation‐induced CNS lymphoma appears to be quite rare 26 . The expedited tumorigenesis seen in this case might be due to paracrine effects of growth factors from the meningioma microenvironment promoting lymphogenic growth.…”

“…Generally, the time interval between radiation exposure and the development of a second CNS neoplasm is much longer than seen in this case. One report describes the development of PCNSL 6 years post‐whole‐brain irradiation 26 . Median time to the development of a post‐radiation malignancy was 10 years according to the Late Effects Study Group 27 .…”

“…Median time to the development of a post‐radiation malignancy was 10 years according to the Late Effects Study Group 27 . Ionizing radiation is known to induce brain neoplasms unequivocally, with the most frequent being meningiomas, sarcomas and gliomas 26,28 . Yet, radiation‐induced CNS lymphoma appears to be quite rare 26 .…”

Primary central nervous system lymphoma

“…PCNSL has also been described in association with a lowgrade astrocytoma (Giromini et al 1981), hepatocellular carcinoma, meningioma and squamous cell carcinoma (Yamasaki et al 1992;Ildan et al 1995). PCNSL has been reported after whole brain irradiation for a low-grade glioma (Stein et al 1995).…”

in vitro- and in vivo Evaluation of Methotrexate-Loaded Hydrogel Nanoparticles Intended to Treat Primary CNS Lymphoma via Intranasal Administration

“…Drug delivery to CNS is harshly restricted via physiological mechanisms including BBB and blood-cerebrospinal fluid barrier (BCSFB), as well as biochemical barriers consist of various enzymes and transporters. CNS malignancies, despite their low prevalence, have very high mortality rate that could be due to drugs' poor access to CNS (12).…”