Primary lymphoma of the brain

Definition:

A malignancy (cancer) of the brain without evidence that it has spread from somewhere else in the body.

Alternative Names:

Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain

Causes, incidence, and risk factors:

The cause of primary brain lymphoma is unknown, but it is more common in people between the ages of 45 and 70 years old and in people with weakened immune systems. As a result, it is a neoplasm that occurs in AIDS patients. Personality changes, seizures, or neurological changes are often the initial symptoms.

The incidence is rising, but primary brain lymphoma is still relatively rare. It occurs in 30 people per million.

Symptoms:

Personality change
Mental status change
Changes in speech
Weakness in hands
Numbness to hot, cold, and pain
Seizures
Headache
Hallucinations

Signs and tests:

Tests that indicate primary lymphoma of the brain include:

A brain biopsy that shows lymphoma
A cranial CT scan that shows brain lesion
CSF total protein, increased
CSF cell count that shows increased white blood cells or lymphoma cells

Treatment:

Initial treatment is with corticosteroids. However, to increase the chance of survival, these tumors need to be treated with radiation therapy and chemotherapy. The chemotherapy is usually given both intravenously and intrathecally (via the spinal cord).

Expectations (prognosis):

The survival of untreated primary brain lymphoma is under 2 months. However, with radiation and chemotherpay the median survival increases to 44 months. About 40% of patients are alive at 5 years. Older patients have a worse prognosis.

Complications:

Possible complications include:

Radiation side effects, including confusion, headaches, neurologic deficits, and radiation necrosis
Chemotherapy side effects, including low blood counts
Recurrence of the lymphoma

Calling your health care provider:

Call your health care provider if unexplained personality, mental status changes or other symptoms suggestive of primary brain lymphoma occur, or if new symptoms develop in a person diagnosed with this disorder.

Review Date: 11/7/2002
Reviewed By: Ezra E. W. Cohen, M.D., Department of Medicine, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.

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