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Hanne Kuitunen, Susanna Tokola, Topi Siniluoto, Matti Isokangas, Eila Sonkajärvi, Seppo Alahuhta, Taina Turpeenniemi-Hujanen, Esa Jantunen, Tapio Nousiainen, Kaija Vasala, Outi Kuittinen
Primary central nervous system lymphoma (PCNSL) is a rare brain tumour with a dismal prognosis. Several phase II studies with high-dose methotrexate-based regimens have shown promising early results, but in all hospital-based data published so far, the disease outcome has been poor. Patients with relapsed or refractory disease have a dismal prognosis. We performed retrospective analysis to evaluate results and tolerabilities of BBBD therapy in combination with high-dose therapy supported by autologous stem cell transplantation...
October 17, 2016: Journal of Neuro-oncology
Michael Scordo, Valkal Bhatt, Meier Hsu, Antonio M Omuro, Matthew J Matasar, Lisa M DeAngelis, Parastoo B Dahi, Craig H Moskowitz, Sergio A Giralt, Craig S Sauter
High-dose therapy and autologous stem cell transplantation (HDT-ASCT) with thiotepa, busulfan, cyclophosphamide (TBC) conditioning has emerged as an effective post-induction treatment strategy for patients with primary (PCNSL) or secondary central nervous system lymphoma (SCNSL), but it is associated with considerable toxicity and transplant-related mortality (TRM) in the modern era. Forty-three adult patients with chemosensitive PCNSL or SCNSL received TBC conditioned ASCT between 2006 and 2015. Twenty-eight of these patients received pharmacokinetically (PK)-targeted busulfan dosing...
October 3, 2016: Biology of Blood and Marrow Transplantation
Wataru Kishimoto, Momoko Nishikori, Hiroshi Arima, Hiroaki Miyoshi, Yuya Sasaki, Toshio Kitawaki, Kotaro Shirakawa, Takeharu Kato, Yoshitaka Imaizumi, Takayuki Ishikawa, Hitoshi Ohno, Hironori Haga, Koichi Ohshima, Akifumi Takaori-Kondo
Primary central nervous system lymphoma (PCNSL) is a distinct subtype of extranodal lymphoma with aggressive clinical course and poor outcome. As increased IL-10/IL-6 ratio is recognized in the cerebrospinal fluid (CSF) of PCNSL patients, we hypothesized that PCNSL might originate from a population of B cells with high IL-10-producing capacity, an equivalent of "regulatory B cells" in mice. We intended in this study to clarify whether Tim-1, a molecule known as a marker for regulatory B cells in mice, is expressed in PCNSL...
October 5, 2016: Cancer Medicine
Bruno Splavski, Dario Muzevic, Tatjana Ladenhauser-Palijan, Brano Splavski
INTRODUCTION: Primary central nervous system lymphoma (PCNSL) of T-cell origin is an exceptionally rare, highly malignant intracranial neoplasm. Although such a tumor typically presents with a focal mass lesion. CASE REPORT: Past medical history of a 26-year-old male patient with a PCNS lymphoma of T-cell origin was not suggestive of intracranial pathology or any disorder of other organs and organic systems. To achieve a gross total tumor resection, surgery was performed via osteoplastic craniotomy using the left frontal transcortical transventricular approach...
July 27, 2016: Medical Archives
Nina Brawanski, Johannes Atta, Lutz M Weise, Jürgen Konczalla, Johanna Quick-Weller, Marie T Forster, Gerhard Marquardt, Volker Seifert, Christian Senft
BACKGROUND: Central nervous system lymphomas (CNSL) are traditionally regarded as non-surgically treated tumors with a poor prognosis. Usually, only stereotactic biopsy is performed to establish the diagnosis, and most patients show disease progression within half a year. A recent study questioned this view, since patients who had surgical resection of PCNSL manifestations prior to adjuvant therapy reportedly had a better outcome than patients who had biopsy only. METHODS: We performed a retrospective analysis of our patient database to identify patients with CNSL who had undergone "accidental" tumor removal in our department between 2002 and 2013...
September 28, 2016: Journal of Neurosurgical Sciences
Yoshiko Okita, Yoshitaka Narita, Yasuji Miyakita, Ruriko Miyahara, Makoto Ohno, Masamichi Takahashi, Masahiro Nonaka, Yonehiro Kanemura, Shin Nakajima, Toshiyuki Fujinaka
Chemoradiotherapy for primary central nervous system lymphoma (PCNSL) is associated with a considerable risk of long-term neurotoxicity. The present study aimed to assess the health-related quality of life (HRQOL) of outpatients with PCNSL who have received radiotherapy and high-dose methotrexate (HDMTX) chemotherapy, and to determine the factors that cause a decline in HRQOL and interfere with home living. A total of 37 patients were surveyed 0.9-14.2 years after their initial diagnosis and treatment. Each patient completed a multi-part HRQOL questionnaire that was used to examine the associations of HRQOL scores with leukoencephalopathy, Karnofsky performance status (KPS) scores, age, history of recurrence and HDMTX-based chemoradiotherapy...
September 2016: Molecular and Clinical Oncology
A Tarabay, G Cossu, M Berhouma, M Levivier, R T Daniel, M Messerer
Primary intracranial lymphomas (Weller et al. in Neuro Oncol 14(12):1481-1484, 2012) are an emerging disease and an isolated localization in the pituitary gland i.e. primary pituitary lymphoma (PPL) represents a rare condition. We present an update of the most recent evidence for PPL through a systematic review of the literature. A systematic literature review was conducted using PubMed database up to October 2015. The population was defined as immunocompetent patients with a pathologically confirmed diagnosis of PPL...
August 31, 2016: Journal of Neuro-oncology
Neel K Gupta, Amber Nolan, Antonio Omuro, Erin G Reid, Chia-Ching Wang, Gabriel Mannis, Michael Jaglal, Julio C Chavez, Paul G Rubinstein, Ann Griffin, Donald I Abrams, Jimmy Hwang, Lawrence D Kaplan, Judith A Luce, Paul Volberding, Patrick A Treseler, James L Rubenstein
BACKGROUND: The optimal therapeutic approach for patients with AIDS-related primary central nervous system lymphoma (AR-PCNSL) remains undefined. While its incidence declined substantially with combination antiretroviral therapy (cART), AR-PCNSL remains a highly aggressive neoplasm for which whole brain radiotherapy (WBRT) is considered a standard first-line intervention. METHODS: To identify therapy-related factors associated with favorable survival, we first retrospectively analyzed outcomes of AR-PCNSL patients treated at San Francisco General Hospital, a public hospital with a long history of dedicated care for patients with HIV and AIDS-related malignancies...
August 30, 2016: Neuro-oncology
Andres M Alvarez-Pinzon, Aizik L Wolf, Heather Swedberg, Sammie R Coy, Jose E Valerio
BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare cancer accounting for less than 3% of primary brain and central nervous system (CNS) tumors. Tissues involved include the brain parenchyma, leptomeninges, eyes, and spinal cord. High-dose methotrexate (MTX) is the gold standard for newly diagnosed PCNSL. However, Gamma Knife radiosurgery (GKRS) may be efficacious as a co-adjuvant treatment. The purpose of this prospective observational cohort study is to determine the effectiveness of MTX in combination with GKRS in the treatment of PCNSL...
July 18, 2016: Curēus
Iole Cordone, Serena Masi, Mariantonia Carosi, Antonello Vidiri, Francesco Marchesi, Mirella Marino, Stefano Telera, Alessia Pasquale, Andrea Mengarelli, Laura Conti, Edoardo Pescarmona, Andrea Pace, Carmine M Carapella
BACKGROUND: Brain stereotactic biopsy (SB) followed by conventional histopathology and immunohistochemistry (IHC) is the gold standard approach for primary central nervous system lymphoma (PCNSL) diagnosis. Flow cytometry (FCM) characterization of fine-needle aspiration cytology and core needle biopsies are increasingly utilized to diagnose lymphomas however, no biological data have been published on FCM characterization of fresh single cell suspension from PCNSL SB. The aim of this study was to establish the feasibility and utility of FCM for the diagnosis and characterization of brain lymphomas from a tissue samples obtained by a single SB disaggregation...
2016: Journal of Experimental & Clinical Cancer Research: CR
Li Fu, Li Chen, Na Wei, Da-Yong Huang, Jing Shen, Jing-Shi Wang, Yi-Ni Wang, Hua Cui, Ling-Zhi Yang, Zhao Wang
OBJECTIVE: To investigate the clinical characteristics, therapeutic outcomes and prognostic factors of primary central nervous system lymphoma (PCNSL). METHODS: Clinical records of 31 cases of PCNSL were collected, the clinical charactenstics were analyzed retrospectively. Survival curves were estimated using Kaplan-Meier survival methodology and statistical significance of continuous variables was assessed via the Cox proportional hazard model. RESULTS: The median age was 52 years, with a ratio of male to female 1:1...
August 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
Naoki Nitta, Satoshi Nakasu, Ayako Shima, Kazuhiko Nozaki
BACKGROUND: Mammalian target of rapamycin (mTOR) complex 1 (mTORC1) acts as a downstream effector of phosphatidyl-inositol-3 kinase, which is frequently hyperactivated in glioblastoma multiforme and links to cell signaling in cellular proliferation, differentiation, metabolism, and survival. Although many studies have suggested the importance of mTORC1 in tumorigenesis, its role remains unclear in brain tumors other than glioblastoma. METHODS: In the present study, we evaluated the activation of mTORC1 in 24 cases of primary central nervous system lymphoma (PCNSL)...
2016: Surgical Neurology International
Uiju Cho, Woo Jin Oh, Yong-Kil Hong, Youn Soo Lee
In diffuse large B-cell lymphoma (DLBCL), the germinal center B-cell (GCB) subtype is associated with a better prognosis compared with the nongerminal center B-cell-like (non-GCB) subtype. However, validity of this immunohistochemical subgrouping in primary DLBCL of the central nervous system is unclear. A total 45 cases of primary central nervous system lymphoma (PCNS)/DLBCL were selected, and immunohistochemistries for CD10, Bcl-6, MUM1, and Ki-67 were performed. Each of the cases was subclassified as either GCB or non-GCB based on its immunoprofile...
August 3, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
Mehar Chand Sharma, Rakesh Kumar Gupta, Seema Kaushal, Vaishali Suri, Chitra Sarkar, Manmohan Singh, S S Kale, Ranjit K Sahoo, Lalit Kumar, Vinod Raina
BACKGROUND & OBJECTIVES: Primary central nervous system lymphomas (PCNSLs) are relatively uncommon, accounting for 2-3 per cent of primary brain tumours. Majority of these are diffuse large B cell lymphomas (DLBCL) occurring both in immunocompromised and immunocompetent patients. We undertook this study to classify PCNSL into germinal centre (GC) and non-germinal centre (NGC) type based on Hans classification and to find the role of Epstein-Barr virus (EBV) in pathogenesis both by conventional immunohistochemistry (IHC) and chromogenic in situ hybridization (CISH)...
May 2016: Indian Journal of Medical Research
María Del Mar Jiménez de la Peña, Lidia Gómez Vicente, Raquel Cano Alonso, Silvia Fuertes Cabero, Antonio Maldonado Suárez, Vicente Martínez de Vega
Primary central nervous system lymphoma (PCNSL) is an uncommon variant of extranodal non-Hodgkin lymphoma, which involves the brain, leptomeninges, eyes, or spinal cord without evidence of systemic disease. In addition to a detailed history and physical examination, the evaluation of patients suspected of having a PCNSL should include a contrast-enhanced magnetic resonance imaging. Occassionaly, PCNSL shows peculiarities on magnetic resonance imaging, which delay the diagnosis and thus the start of treatment...
April 27, 2016: Current Problems in Diagnostic Radiology
Mashary Binnahil, Karolyn Au, Jian-Qiang Lu, Blaise Matthew Wheatley, Tejas Sankar
Classical neurosurgical teaching suggests that corticosteroid administration reduces the diagnostic yield of stereotactic brain biopsy for primary central nervous system lymphoma (PCNSL). In a single-center series spanning 6 years, we reviewed 155 consecutive biopsy patients, 135 treated with prebiopsy corticosteroids. PCNSL was correctly diagnosed on initial biopsy in 15 of 16 steroid-treated patients; in the single nondiagnostic specimen, polymerase chain reaction reanalysis by an outside institution showed evidence of lymphoproliferative disease consistent with PCNSL...
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Seyed Ali Nabavizadeh, Arastoo Vossough, Mehrdad Hajmomenian, Reza Assadsangabi, Suyash Mohan
Primary central nervous system lymphoma (PCNSL) is a rare aggressive high-grade type of extranodal lymphoma. PCNSL can have a variable imaging appearance and can mimic other brain disorders such as encephalitis, demyelination, and stroke. In addition to PCNSL, the CNS can be secondarily involved by systemic lymphoma. Computed tomography and conventional MRI are the initial imaging modalities to evaluate these lesions. Recently, however, advanced MRI techniques are more often used in an effort to narrow the differential diagnosis and potentially inform diagnostic and therapeutic decisions...
August 2016: Hematology/oncology Clinics of North America
Yoon Seong Choi, Ho-Joon Lee, Sung Soo Ahn, Jong Hee Chang, Seok-Gu Kang, Eui Hyun Kim, Se Hoon Kim, Seung-Koo Lee
OBJECTIVES: To evaluate the ability of the initial area under the curve (IAUC) derived from dynamic contrast-enhanced MR imaging (DCE-MRI) and apparent diffusion coefficient (ADC) in differentiating between primary central nervous system lymphoma (PCNSL) and atypical glioblastoma (GBM). METHODS: We retrospectively identified 19 patients with atypical GBM (less than 13 % necrosis of the enhancing tumour), and 23 patients with PCNSL. The histogram parameters of IAUC at 30, 60, 90 s (IAUC30, IAUC60, and IAUC90), and ADC were compared between PCNSL and GBM...
July 19, 2016: European Radiology
Masahiro Kitao, Noriyasu Hashida, Kohji Nishida
BACKGROUND: Primary vitreoretinal lymphoma (PVRL) is a rare and fatal ocular malignancy that is mostly classified as diffuse large B cell lymphoma (DLBCL). PVRL is often fatal because of its association with the central nervous system (CNS). PVRL frequently masquerades as uveitis and sometimes recurs in clinical findings as keratic precipitates (KPs) and subretinal lesions. Pseudohypopyon is one of the clinical findings of the local recurrence of PVRL and is treated with radiotherapy; however, the effectiveness of local control with an intravitreal injection of methotrexate (MTX) has not yet been determined...
July 8, 2016: BMC Ophthalmology
W-Y Huang, J-B Wen, G Wu, B Yin, J-J Li, D-Y Geng
BACKGROUND AND PURPOSE: Whether ADC value predicts the therapy response and outcomes of primary central system lymphoma remains controversial. This study assessed the minimum ADC correlated with treatment response in patients with primary central nervous system lymphoma undergoing methotrexate-based chemotherapy. MATERIALS AND METHODS: Thirty-five patients with primary central nervous system lymphoma underwent conventional MR imaging and DWI before chemotherapy and after 1 and 5 cycles of chemotherapy...
July 7, 2016: AJNR. American Journal of Neuroradiology
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