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Primary cns lymphoma

Osnat Bairey, Tali Siegal
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive brain tumor. The prognosis is poor, with high rates of relapse and disease progression after treatment. In addition, PCNSL affects a largely older population, so that a significant proportion of patients are ineligible for intensive therapies and high-dose chemotherapy. The elderly patients are also susceptible to the accelerated and detrimental cognitive side effects of whole-brain irradiation which is an alternative consolidation to high-dose chemotherapy...
March 11, 2018: Blood Reviews
Kieron Dunleavy, Tabea Erdmann, Georg Lenz
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous diagnostic category with different molecular subtypes defined by distinct gene expression patterns and divergent mechanisms of oncogenic activation. Several studies have suggested an inferior survival for patients of the activated B-cell-like (ABC) versus the germinal center B-cell-like (GCB) DLBCL subtype which has led to increasing interest in investigating pharmacological inhibition of signaling pathways which contribute to lymphomagenesis and that are specifically utilized by ABC DLBCL cells...
February 1, 2018: Cancer Treatment Reviews
Sarah Löw, Tracy T Batchelor
Primary central nervous system lymphoma (PCNSL) is an extranodal non-Hodgkin lymphoma limited to the brain, spinal cord, leptomeninges, and eyes. The majority of patients are immunocompetent, with a median age of 65 years at diagnosis. Historically, whole-brain radiation therapy (WBRT) was the first and sole treatment for PCNSL. Today, due to the recognized neurotoxicity of WBRT, this modality is usually avoided in the treatment. Most chemotherapy regimens are based on high-dose methotrexate plus the anti-CD20 monoclonal antibody rituximab, leading to high response rates, but 5-year survival is still poor at approximately 30% compared with other extranodal lymphomas...
February 2018: Seminars in Neurology
Guro Jahr, Michele Da Broi, Harald Holte, Klaus Beiske, Torstein R Meling
Objectives: To evaluate the validity of Memorial Sloan-Kettering Cancer Center (MSKCC) and International Extranodal Lymphoma Study Group (IELSG) prognostic scoring systems for Overall Survival (OS) in intracranial Primary CNS lymphoma (PCNSL) of all patients diagnosed at a single center. Material and Methods: Pretreatment clinical factors including tumor characteristics and histology, treatment, and survival of PCNSL patients with diagnostic biopsies over a 12-year period (2003-2014) were retrieved from a prospective database at Oslo University Hospital...
March 2018: Brain and Behavior
Altaf Ali Laghari, Syed Ijlal Ahmed, Adnan Jabbar, Muhammad Shahzad Shamim
Primary CNS lymphoma (PCNSL) is a rare and aggressive brain tumour that is uniformly fatal. The rarity of the disease and the poor response to treatment makes it difficult to reach a consensus with regards to treatment options. In this review, the authors have discussed different treatment modalities used in the management of PCNSL including chemotherapy, surgery and radiation, as well as the results of recent clinical trials on treatment options for PCNSL.
March 2018: JPMA. the Journal of the Pakistan Medical Association
Masahide Matsuda, Eiichi Ishikawa, Tetsuya Yamamoto, Kentaro Hatano, Akira Joraku, Yuichi Iizumi, Yosuke Masuda, Hiroyuki Nishiyama, Akira Matsumura
Tumor angiogenesis has attracted increasing attention because of its potential as a valuable marker in the differential diagnosis of brain tumors as well as a novel therapeutic target. Prostate-specific membrane antigen (PSMA) is expressed by the neovasculature endothelium of some tumors, with little to no expression by the tumor cells or normal vasculature endothelium. The aim of this study was to investigate the potential of PSMA for the evaluation of the tumor neovasculature of various brain tumors and the possibility of detecting PSMA expression in brain tumors using PET imaging with89 Zr-Df-IAB2M (anti-PSMA minibody)...
March 9, 2018: Journal of Neuro-oncology
Stefan Schob, Benno Münch, Julia Dieckow, Ulf Quäschling, Karl-Titus Hoffmann, Cindy Richter, Nikita Garnov, Clara Frydrychowicz, Matthias Krause, Hans-Jonas Meyer, Alexey Surov
PURPOSE: Diffusion weighted imaging (DWI) quantifies motion of hydrogen nuclei in biological tissues and hereby has been used to assess the underlying tissue microarchitecture. Histogram-profiling of DWI provides more detailed information on diffusion characteristics of a lesion than the standardly calculated values of the apparent diffusion coefficient (ADC)-minimum, mean and maximum. Hence, the aim of our study was to investigate, which parameters of histogram-profiling of DWI in primary central nervous system lymphoma can be used to specifically predict features like cellular density, chromatin content and proliferative activity...
March 6, 2018: Translational Oncology
Xiaoke Li, Shuo Qi, Yuntao Jiao, Jing Gao, Hongbo Du
RATIONALE: Primary central nervous system lymphoma (PCNSL) with initial manifestations of constipation and intestinal obstruction (IO) is rare. PATIENT CONCERNS: A 50-year-old Chinese male patient was admitted to the gastroenterology department due to constipation and abdominal distention for 8 days. He had experienced intermittent back pain for 3 years prior to admission. Based on abdominal radiography, he was initially diagnosed with IO and treated with meal restriction and enemas...
March 2018: Medicine (Baltimore)
Tilman Hottenrott, Elisabeth Schorb, Kristina Fritsch, Rick Dersch, Benjamin Berger, Daniela Huzly, Sebastian Rauer, Ludger Tebartz van Elst, Dominique Endres, Oliver Stich
Some patients with primary central nervous system lymphoma (PCNSL) may initially present with similar clinical, magnetic resonance imaging, and routine cerebrospinal fluid (CSF) findings as those observed in multiple sclerosis (MS). The MRZ reaction (MRZR), composed of the three respective antibody indices (AIs) against measles, rubella, and varicella zoster virus, appears to be the most specific CSF marker for MS. This study aimed to determine whether a positive MRZR and other routine CSF markers help differentiate between MS and PCNSL...
March 6, 2018: Journal of Neurology
Rimas V Lukas, Peter Riedell, Peleg M Horowitz, Peter Pytel, David O Kamson
The diagnosis of primary central nervous system lymphoma (PCNSL) may be fraught with difficulty. After initial imaging reveals enhancing intracranial mass lesions steroids are often initiated. This leads to a decreased diagnostic yield of tumor biopsies which may be associated with delay in treatment initiation. We review a case of PCNSL treated with a very brief steroid course. Initial nondiagnostic biopsy histopathology is juxtaposed against subsequent diagnostic pathology. Imaging before and after steroids is presented, as is imaging after tumor regrowth in a noncontiguous location...
March 2018: Neurologist
Rimas V Lukas, Vinai Gondi, Roger Stupp, Jeffrey J Raizer
Primary central nervous system (CNS) lymphoma, a rare CNS neoplasm associated with high mortality, is responsive to therapeutic interventions. In Part 1 of our two-part coverage of this entity, we provided an overview of the epidemiology of primary CNS lymphoma, followed by a discussion of the diagnostic and staging evaluation, and a review of current prognostication systems. In Part 2, we discuss the management of primary CNS lymphoma, focusing in particular on systemic therapies and radiation. With respect to systemic therapies, we provide details of a variety of regimens built around a backbone of high-dose methotrexate...
February 15, 2018: Oncology (Williston Park, NY)
Lauren R Schaff, Christian Grommes
PURPOSE OF REVIEW: Primary central nervous system lymphoma (PCNSL) is an aggressive malignancy confined to the brain, spinal cord, leptomeninges, and eyes. Due to its rarity, there is a paucity of randomized trials and a varied approach to its management in the oncologic community. This review summarizes recent literature guiding current clinical practice. RECENT FINDINGS: The presentation, work up, and management of PCNSL are discussed. Induction therapy incorporates a methotrexate-based chemotherapy regimen and is generally followed by a consolidation regimen including high dose chemotherapy (with or without autologous stem cell rescue)...
February 28, 2018: Current Oncology Reports
Adil Nazir, Fawad, Neelam Siddique, Abdul Hameed
Background and Objective: Central nervous system (CNS) relapse of diffuse large B cell lymphoma (DLBCL) is relatively uncommon and nearly fatal. Two years CNS relapse risk is 0.8% in low, 3.9% in intermediate and 12% in high risk patients. Our aim was to study, the baseline characteristics and outcome in term of median survival of DLBCL patients with CNS relapse. Methods: This is a retrospective analysis. All patients of DLBCL with CNS relapse from 2006 to 2014 were included...
November 2017: Pakistan Journal of Medical Sciences Quarterly
E Gómez Roselló, A M Quiles Granado, G Laguillo Sala, S Pedraza Gutiérrez
Primary central nervous system (CNS) lymphomas are uncommon and their management differs significantly from that of other malignant tumors involving the CNS. This article explains how the imaging findings often suggest the diagnosis early. The typical findings in immunocompetent patients consist of a supratentorial intraaxial mass that enhances homogeneously. Other findings to evaluate include multifocality and incomplete ring enhancement. The differential diagnosis of primary CNS lymphomas should consider mainly other malignant tumors of the CNS such as glioblastomas or metastases...
February 23, 2018: Radiología
Lauriane Goldwirt, Kevin Beccaria, Alain Ple, Hélène Sauvageon, Samia Mourah
PURPOSE: Central nervous system (CNS) dissemination occurs in 4.1% of mantle cell lymphoma (MCL) patients and clinically significant CNS involvement in chronic lymphocytic leukemia (CLL) patients reaches 4%. Ibrutinib, an orally administered Bruton's tyrosine kinase (BTK) inhibitor, has shown substantial activity in CLL or MCL patients with CNS localization, and in primary central nervous system lymphoma (PCNSL). The drug efficacy to treat primary or secondary CNS impairments relies on its brain distribution through the blood-brain barrier (BBB), the aim of the present work was to study the brain distribution of ibrutinib using an in vivo mice model...
February 23, 2018: Cancer Chemotherapy and Pharmacology
Naoki Shinojima, Kenji Fujimoto, Keishi Makino, Kohei Todaka, Kazumichi Yamada, Yoshiki Mikami, Kazutaka Oda, Kazumi Nakamura, Hirofumi Jono, Jun-Ichi Kuratsu, Hideo Nakamura, Shigetoshi Yano, Akitake Mukasa
The therapeutic response to high-dose methotrexate (HD-MTX) therapy for primary central nervous system lymphoma (PCNSL) varies. Polyglutamylation is a reversible protein modification with a high occurrence rate in tumor cells. MTX incorporated into cells is polyglutamylated and strongly binds to dihydrofolate reductase without competitive inhibition by leucovorin (LV). Tumor cells with high polyglutamylation levels are selectively killed, whereas normal cells with lower polyglutamylation are rescued by LV. We hypothesized that the extent of polyglutamylation in tumor cells determines treatment resistance...
February 23, 2018: Acta Neuropathologica Communications
Rudy Birsen, Lise Willems, Johan Pallud, Estelle Blanc, Barbara Burroni, Marielle Legoff, Emmanuelle Le Ray, Sylvain Pilorge, Benedicte Deau, Patricia Franchi, Marguerite Vignon, Yioulia Kirova, Myriam Edjlali, Caroline Houillier, Carole Soussain, Pascale Varlet, Edouard Dezamis, Diane Damotte, Didier Bouscary, Jerome Tamburini
No abstract text is available yet for this article.
February 22, 2018: Haematologica
Ruby Del Risco Kollerud, Karl Gerhard Blaasaas, Bjørgulf Claussen, Per Nafstad, Lisa A Cannon-Albright, Ellen Ruud, Finn Wesenberg, Øyvind Næss
BACKGROUND: It is not clear if family history of cancer increases risk of cancer in children. METHODS: We followed-up a total of 2 610 937 children born between 1960 and 2001 for cancer risk, and their parents and siblings. In this period, 2477 primary childhood solid tumours (except lymphoma) were diagnosed. The data from the Norwegian Family and Life Course Study and from the Norwegian Cancer Register were used. Classification of hereditary cancer syndromes was based on tumour histology, pedigrees and Chompret's criteria...
February 20, 2018: British Journal of Cancer
Rimas V Lukas, Roger Stupp, Vinai Gondi, Jeffrey J Raizer
Primary central nervous system (CNS) lymphoma is a rare CNS neoplasm. Its highest incidence is in the elderly and the immunocompromised. The initial steps in establishing a diagnosis involve CNS imaging. Familiarity with the clinical presentation is important in order to limit the risk of a nondiagnostic biopsy. In addition to confirming the diagnosis, it is wise to evaluate for extra-CNS disease. There are important differences in the presentation and evaluation of immunocompetent patients and those of immunocompromised patients; we will delineate these in this review...
January 15, 2018: Oncology (Williston Park, NY)
Daesung Kang, Ji Eun Park, Young-Hoon Kim, Jeong Hoon Kim, Joo Young Oh, Jungyoun Kim, Yikyung Kim, Sung Tae Kim, Ho Sung Kim
Background: Radiomics is a rapidly growing field in neuro-oncology, but studies have been limited to conventional MRI and external validation is critically lacking. We evaluated technical feasibility, diagnostic performance, and generalizability of a diffusion radiomics model for identifying atypical primary central nervous system lymphoma (PCNSL) mimicking glioblastoma. Methods: Total 1618 radiomics features were extracted from diffusion and conventional MRI from 112 patients (training set, 70 glioblastomas and 42 PCNSLs)...
February 9, 2018: Neuro-oncology
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