Presentation
Primary central nervous system lymphoma (PCNSL) is an uncommon extranodal manifestation of non-Hodgkin's lymphoma with those presenting at the cerebellopontine angle (CPA) being rare presentations with limited reported cases in the literature. [ncbi.nlm.nih.gov]
Entire Body System
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Hodgkin Lymphoma
Herein, for the first time, we describe the radiologic and pathologic features of a primary CNS posttransplantation lymphoproliferative disease that reveals Epstein-Barr virus-positive Hodgkin lymphoma. [ncbi.nlm.nih.gov]
Gonzalez GD, Schuster-Uitterhoeve ALJ: Primary non-Hodgkin's lymphoma of the central nervous system. Cancer 51: 2048–2052, 1983 Google Scholar 12. [doi.org]
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Fatigue
Less common side effects may include convulsion, severe headache, severe fatigue, low blood count, infection. Rare side effects may include pneumonia due to Pneumocystis carinii organism. Cytarabine (Ara-C) is an intravenous chemotherapy drug. [sjo.org]
The cause of the condition is unknown, though genetic mutations have been implicated The condition can cause headaches, fatigue, convulsions, and other general signs and symptoms, such as fever, weight loss, and appetite loss. [dovemed.com]
Some experience fatigue, headache and inflammation of the external auditory canal or middle ear • Patients requiring treatment of the eye are likely to experience conjunctival irritation and dry eye. • These acute effects typically resolve within 6 – [slideshare.net]
The side effects of whole-brain radiotherapy can include: worsening of your symptoms in the early stages of treatment fatigue – this might take some months to improve after treatment poor attention poor memory problems with language slowness of thinking [lymphomas.org.uk]
Eyes
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Diplopia
We report a 66-year-old man with 2-month history of dizziness and 1-month history of diplopia. Cranial magnetic resonance imaging (MRI) disclosed two solid masses, one in the right lateral ventricle and another in the fourth ventricle. [ncbi.nlm.nih.gov]
Systemic symptoms may include fever, night sweats, or weight loss.Other symptoms include diplopia dysphagia vertigo monocular vision loss progressive dementia or stupor in patients with a nonfocal neurologic exam and minimal abnormalities on MRI (more [en.wikipedia.org]
N/A A homogeneously enhancing mass within the fourth ventricle without hydrocephalus Excision Diffuse large B-cell lymphoma Chemotherapy and WBRT 6 months without recurrence Gossmanet al. [8]2014 66/M Progressive gait disturbances and diplopia N/A A [omicsonline.org]
Such patients give a history of (1) blurred vision, (2) headache, (3) isolated cranial nerve dysfunction (eg, diplopia, dizziness, dysphagia, facial numbness, monocular visual loss), or (4) spinal nerve root symptoms (eg, pain, dysfunction localized to [emedicine.medscape.com]
Neurologic
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Headache
No headache was reported on admission, but previously she had intermittent mild headaches and generalized body aches. She had no history of visual symptoms. [ncbi.nlm.nih.gov]
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Seizure
The boy had a history of walking weakness and seizure for 4 months. The serum levels of immunoglobulin G, A and M were decreased. Brain MRI showed multiple lesions which had ring enhancement. CT showed calcification in all of the lesions. [ncbi.nlm.nih.gov]
Anticonvulsants may be given if seizures occur as a result of a tumour. [leukaemia.org.au]
Symptoms Non-focal, non-specific symptoms occur in more than 50 percent of patients; mental status changes in one third; symptoms of increased intracranial pressure (headache, nausea/vomiting) and/or generalized seizures in 9 percent. [neurosurgery.ucla.edu]
Symptoms: The most common symptoms of CNS lymphoma are changes in behavior, weakness on one side of the body, seizures, or symptoms of increased intracranial pressure such as headache, nausea, vomiting, and vision changes. [ucdenver.edu]
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Confusion
Her family said she was mildly confused and had memory difficulties that started acutely 2 days before presentation to the hospital. [ncbi.nlm.nih.gov]
Symptoms and signs of PCNSL vary, depending on the area of the brain that is involved and include severe headaches, changes in speech, personality changes, confusion, memory problems, drowsiness, muscle weakness, and numbness in the extremities. [secure.ssa.gov]
Depend on where the tumor is, the symptoms can include: Throwing up or feeling like you’re going to Weakness in your legs and arms Seizures Headaches Confusion Double vision Hearing loss Trouble swallowing Trouble with balance and coordination Continued [webmd.com]
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Cognitive Impairment
The serial Montreal Cognitive Assessment evaluations (20-72 months post chemotherapy) of 10 long-term CR patients revealed one dementia among three patients without WBRT and five mild cognitive impairments in seven patients with WBRT. [ncbi.nlm.nih.gov]
Over time studies have shown that while it may initially lead to superior progression free survival the cognitive impairment is too substantial. [nhlcyberfamily.org]
Treatment induced neurotoxicities include vincristine neuropathy, ifosfamide or cytarabine encephalopathy, radiation myelopathy, or radiation related cognitive impairment. [jnnp.bmj.com]
Impairment CTFPHC Addictions Anxiety Bipolar Depression Obsessive Compulsive Disorder Pediatrics Psychosis Psychosomatic Acute Kidney Injury Chronic Kidney Disease Fluids & Electrolytes Glomerulonephritis Hemodialysis Hypertension REFERENCE BOOK Screening [qxmd.com]
Neurotoxicity can occur and is especially notable for patients older than 60 years, who can develop cognitive impairment after standard doses of whole-brain radiation. [hematologyandoncology.net]
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Focal Neurologic Deficit
A primary CNS lymphoma usually presents with seizure, headache, cranial nerve findings, altered mental status, or other focal neurological deficits typical of a mass effect. [en.wikipedia.org]
The most common presenting symptom is progressive focal neurologic deficit, which is seen in 70% of patients. [clinicaladvisor.com]
Patients with PCNSL present with focal neurological deficits, neuropsychiatric symptoms, signs of raised intracranial pressure, and seizures. [ci.nii.ac.jp]
Patients with this diagnosis often present similarly to those diagnosed with other brain malignancies, and include focal neurologic deficits, neurocognitive symptoms, headaches, seizures, and ocular symptoms. [acanceresearch.com]
Greater than 50% of patients present with focal neurologic deficits such as hemiparesis or aphasia, 35% exhibit alteration in cognition, behavior, or personality, 11% present with seizure, and 32% present with headache, nausea, vomiting and papilledema [oncologynurseadvisor.com]
Workup
Postsurgical pathologic workup revealed malignant B cell lymphoma with morphologic features of diffuse large B cell lymphoma. Eight of these 11 patients with PCNSL showed a clear fluorescence induced by 5-ALA. [ncbi.nlm.nih.gov]
Consultations Ophthalmologic consultation is required as part of the initial workup and staging of PCNSL, in order to exclude vitreous involvement. [emedicine.medscape.com]
Treatment
The optimal treatment for refractory or relapsed PCNSL is poorly defined. The choice of salvage treatment depends on a patient's age, previous treatment and response, performance status, and comorbidities at the time of relapse. [ncbi.nlm.nih.gov]
Prognosis
The overall prognosis, diagnosis, and management of PCNSL differ from those for other types of NHL. Prompt diagnosis and initiation of treatment are vital for improving clinical outcomes. [ncbi.nlm.nih.gov]
Objective: To compare the pathogenesis, clinical presentation, therapy, and prognosis of primary central nervous system lymphoma in immunocompetent persons with these characteristics of the disease in patients with AIDS. [doi.org]
Etiology
Primary central nervous system lymphoma (PCNSL) is a rare malignancy that usually arises in the context of severe immunosuppression but has incompletely understood etiology, limiting effective treatments. [ncbi.nlm.nih.gov]
Etiology The DLBCL type of PCNSL is composed of immunoblasts or centroblasts that have a predilection for blood vessels. Lymphoid clustering around small cerebral vessels is typically seen. [emedicine.medscape.com]
Epidemiology
The epidemiology, therapeutic measures, and clinical characteristics were listed as descriptive statistics. [ncbi.nlm.nih.gov]
The current analysis drew from the updated Surveillance, Epidemiology, and End Results (SEER) database to establish projections for the incidence of brain lymphoma. [doi.org]
Pathophysiology
Clinical, pathophysiological, and diagnostic aspects of sentinel demyelination and PCNSL are discussed. [ncbi.nlm.nih.gov]
There are several hypotheses to explain the origin of B cell primary CNS lymphoma but no definitive data which explain their pathophysiology. [jnnp.bmj.com]
Pathophysiology At least 95% of PCNSL are B-cell neoplasms which express the B-cell marker CD20. [oncologynurseadvisor.com]
Histopathology and molecular pathophysiology PCNSLs are mature B-cell lymphomas characterized by the expression of pan B-cell markers (CD20 and CD79a) (Figure 2). Typically, they have a high proliferation rate (Ki-67 proliferative index 70%). [aerzteblatt.de]
Prevention
From prevention and early detection strategies to treatment, supportive care and survivorship, the Cancer Institute is here for you. [utmedicalcenter.org]
You may have anti-convulsant drugs to prevent seizures (fits). The main treatment for PCNSL is usually chemotherapy. It is often given with a targeted therapy drug called rituximab. [macmillan.org.uk]
Prevention of neurological complications with better systemic therapy and, possibly, prophylactic intrathecal chemotherapy are areas of active investigation. [books.google.com]
How can Primary Central Nervous System Lymphoma be Prevented? Currently, it is not possible to prevent Primary Central Nervous System Lymphoma. However, controlling certain factors my help lower one’s risk for the condition. [dovemed.com]
Our physicians value the relationship they have with each of their patients and encourage each patient to play an active role in disease prevention and management. [sjo.org]