Journal ArticleDOI
Primary central nervous system lymphoma: presentation, diagnosis and staging.
TLDR
Brain biopsy sampling remains the gold standard for PCNSL diagnosis in all patients, although the possibility of establishing routine, minimally invasive diagnostic procedures in which Epstein-Barr virus polymerase chain reaction (PCR) analysis of the CSF and nuclear imaging are used is currently under investigation in the population of patients with AIDS.Abstract:
Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma that affects the brain, spinal cord, leptomeninges, and eyes. The clinical presentation and neuroimaging appearance of PCNSL differ in immunocompetent patients and in those with acquired immunodeficiency syndrome (AIDS). A magnetic resonance (MR) image of the brain in immunocompetent patients with PCNSL typically demonstrates one or more homogeneously enhancing lesions located in the periventricular white matter, characteristically spanning the corpus callosum. In patients with AIDS, multiple ring-enhancing lesions are more common. After neuroimages raising the suspicion of PCNSL are obtained, a definitive diagnosis should be established in both immunocompetent and AIDS patients by performing pathological analysis of cerebrospinal fluid (CSF), vitreous fluid, or a biopsy specimen. Brain biopsy sampling remains the gold standard for PCNSL diagnosis in all patients, although the possibility of establishing routine, minimally invasive diagnostic procedures in which Epstein-Barr virus polymerase chain reaction (PCR) analysis of the CSF and nuclear imaging are used is currently under investigation in the population of patients with AIDS. At the time of diagnosis, the patient should undergo further evaluation, which should include a physical examination, ophthalmic evaluation with a slit-lamp examination, serum lactate dehydrogenase levels, human immunodeficiency virus testing, computed tomography scans of the chest/abdomen/pelvis, bone marrow biopsy sampling, contrast-enhanced brain MR imaging, and lumbar puncture (LP). Testicular ultrasonography studies should be considered in men. In patients who cannot undergo LP or in those with evidence of spinal cord dysfunction, contrast-enhanced MR imaging of the entire spine should be considered.read more
Citations
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Journal ArticleDOI
Central Nervous System Lymphoma: Characteristic Findings on Traditional and Advanced Imaging
TL;DR: New CT and MR imaging techniques and metabolic imaging have demonstrated characteristic findings in CNS lymphoma, aiding in its differentiation from other CNS lesions, and advanced imaging techniques may, in the future, substantially improve the diagnostic accuracy of imaging, ultimately facilitating a noninvasive method of diagnosis.
Journal ArticleDOI
A Systematic Approach to the Diagnosis of Suspected Central Nervous System Lymphoma
TL;DR: A combined stepwise systematic approach outlined here may facilitate an expeditious, comprehensive presurgical evaluation for cases of suspected CNS lymphoma.
Journal ArticleDOI
CT and MR Imaging Features of Primary Central Nervous System Lymphoma in Norway, 1989-2003
TL;DR: White matter periventricular contrast-enhancing single or multiple focal lesions were typical of non-AIDS PCNSL, and no or disseminated lesions heightened the risk of delayed or postmortem diagnosis.
Book ChapterDOI
The viral etiology of AIDS-associated malignancies.
TL;DR: In this article, the authors have shown that HIV-associated cancers will continue to pose a major challenge globally for many years to come, and that the cancers associated with immunosuppressed individuals are those that were found to have viral etiology.
Journal ArticleDOI
MR imaging features of intracranial primary CNS lymphoma in immune competent patients.
TL;DR: In the proper clinical and radiologic setting, suggesting the diagnosis of PCNSL can help institute proper treatment in a timely fashion and avoid unnecessary attempts at surgical resection and the associated morbidity is suggested.
References
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Journal ArticleDOI
Primary central nervous system lymphoma
TL;DR: Although subtypes exist, non-Hodgkin's lymphoma of the CNS most commonly consists of histiocytic cells or large immunoblastic cells bearing B cell surface markers in close proximity to the lateral and third ventricles.
Journal ArticleDOI
Report of an International Workshop to Standardize Baseline Evaluation and Response Criteria for Primary CNS Lymphoma
Lauren E. Abrey,Tracy T. Batchelor,A. J. M. Ferreri,Mary Gospodarowicz,Elisa Jacobsen Pulczynski,Emanuele Zucca,Justine R. Smith,Agnieszka Korfel,Carole Soussain,Lisa M. DeAngelis,Edward A. Neuwelt,Brian P. O'Neill,Eckhard Thiel,Tamara Shenkier,Fransesc Graus,Martin J. van den Bent,John F. Seymour,Philip Poortmans,James O. Armitage,Franco Cavalli +19 more
TL;DR: An international group of experts meeting to review current standards of reporting and to formulate a consensus opinion regarding minimum baseline evaluation and common standards for assessing response to therapy hope that these guidelines will improve communication among investigators and comparability among clinical trials in a way that will allow to develop better therapies for patients.
Book
Magnetic Resonance Imaging of the Brain and Spine
TL;DR: In this paper, the authors present a survey of the main principles of image formation in MR imaging, including instrumentation: Magnets, Coils, and Hardware, contrast development and manipulation, and image formation.
Journal ArticleDOI
Prognostic Scoring System for Primary CNS Lymphomas: The International Extranodal Lymphoma Study Group Experience
Andrés J.M. Ferreri,Jean-Yves Blay,Michele Reni,Felice Pasini,Michele Spina,Achille Ambrosetti,A. Calderoni,Andrea Rossi,V. Vavassori,Annarita Conconi,Liliana Devizzi,Françoise Berger,Maurilio Ponzoni,Bettina Borisch,Marianne Tinguely,Michele Cerati,Mario Milani,Enrico Orvieto,JG Sanchez,Christine Chevreau,Stefania Dell'Oro,Emanuele Zucca,Franco Cavalli +22 more
TL;DR: Age, PS, LDH serum level, CSF protein concentration, and involvement of deep structures of the brain were independent predictors of survival and a prognostic score including these five parameters seems advisable in distinguishing different risk groups in PCNSL patients.
Journal ArticleDOI
Non-Hodgkin's lymphoma of the brain: can high dose, large volume radiation therapy improve survival? Report on a prospective trial by the Radiation Therapy Oncology Group (RTOG): RTOG 8315.
Diana F. Nelson,Karen L. Martz,Hugh Bonner,Hugh Bonner,James S. Nelson,James S. Nelson,Joseph Newall,Herbert D Kerman,John W. Thomson,Kevin Murray +9 more
TL;DR: Despite high dose and large volume irradiation, primary Central Nervous System lymphoma still exhibits excessive mortality, especially in older patients, which remains unresolved, this paradox of the relative radioresistance of primary Central nervous system lymphoma remains unresolved.