Central nervous system (CNS) lymphomas
What is it?
Primary lymphomas account for 0.85-2% of intracranial tumors.
These tumors may arise in the central nervous system (primary lymphoma) or be secondary due to the spread of metastases from another place (1-7% of autopsy cases).
Causes and risk factors
The median age at diagnosis of primary lymphoma is 50 years and the male to female ratio is 1.5.
The incidence of primary lymphoma is increased in patients with collagenous diseases (lupus, Sjogren’s syndrome, rheumatoid arthritis, etc.) or in immunosuppressed patients, especially in AIDS patients (the incidence in the latter is 1.9%).
Which are the symptoms?
The disease often manifests itself with symptoms of endocranial hypertension such as constant headache, vomiting, ideomotor retardation.
How is it diagnosed?
Computed tomography (CT) and magnetic resonance imaging (MRI) are used in diagnosis, but these studies do not reflect specific features; angiography is also of little use.
Once a presumptive diagnosis of central nervous system lymphoma is made, the presence of collagen disease or other diseases often associated with primary lymphomas is checked to rule out the possibility that the tumor originated outside the central nervous system.
How is it treated?
Today, treatment is mainly based on chemotherapy, including intrathecal injection of methotrexate, and radiation therapy.
Surgery plays a role mainly when diagnosed by stereotaxic or open biopsy.
These are tumors that respond well to chemotherapy and radiation therapy, despite being a rather serious disease.
Where do we treat it?
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