Primary non-Hodgkin's lymphomas of the CNS

• Published in: Acta neurologica Scandinavica Vol. 73; no. 6; p. 602
• Main Authors: Bogdahn, U, Bogdahn, S, Mertens, H G, Dommasch, D, Wodarz, R, Wünsch, P H, Kühl, P, Richter, E
• Format: Journal Article
• Language: English
• Published: Denmark 01.06.1986
• Subjects: Adult; Aged; Brain Neoplasms - cerebrospinal fluid; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - pathology; Cerebral Angiography; Child, Preschool; Female; Humans; Lymphoma - cerebrospinal fluid; Lymphoma - diagnostic imaging; Lymphoma - pathology; Male; Middle Aged; Prognosis; Tomography, X-Ray Computed
• ISSN: 0001-6314
• DOI: 10.1111/j.1600-0404.1986.tb04607.x

This paper reports on 10 patients (4 male, 6 female) with primary non-Hodgkin's lymphomas of the brain (CNS-NHL--mean age 46.8 years, mean postdiagnostic survival 10 months). Pathological CSF (cerebrospinal fluid) was found in all 8 patients examined (positive cytology in 7/8 cases). Solitary tumors, diffuse periventricular infiltration or diffuse cerebral infiltration were demonstrated in cerebral computer-assisted tomography (CAT). Angiographical findings were unspecific. The histologic subtypes were lymphoplasmacytoid immunocytoma (4), unclassified low grade (1), centroblastic (1), B-immunoblastic (1), T-immunoblastic (1), lymphoblastic convoluted T-cell type (1), unclassified high grade (1) NHL. Patients who had received radiotherapy (+/- surgery) in this group had a mean survival of 15.66 months (sigma = 7.63). In addition, an overview of 83 well-documented, cases of the literature tries to characterize main histological and topographical distributions, histology-, patient's age-, and therapy-related survival. Patients with primary CNS-NHL have a 5-year survival expectancy of 30% compared with 2.3% in secondary CNS-manifestations of systemic non-Hodgkin's lymphomas. In this report, the beneficial effect of radiotherapy (mean survival 30.3 months) compared to surgery or symptomatic treatment (3.6 or 3.3 months) could be confirmed. It is concluded that primary CNS-NHL frequently present with atypical neuropsychiatric syndromes; diagnosis should be established preferentially with CAT and CSF-examinations or stereotactic biopsies, whereas open surgery should be avoided. An approach to exact classification should be attempted, as survival is clearly related to histological subtypes.