Lymphoma is cancer of the lymphatic cells (white blood cells, in particular). The lymph system is part of the body’s immune system. Lymphoma typically creates solid tumors of the lymphoid cells. When a lymphoma occurs in the intracranial space (area inside the skull), it is called a “central nervous system (CNS) lymphoma.” Medically speaking, most primary CNS lymphomas could be classified as diffuse, large B-cell, non-hodgkin’s lymphoma. Another name for CNS lymphoma is a primary brain lymphoma.
CNS lymphoma is often associated with a compromised immune system (immunosuppression), such as might occur in patients with autoimmune deficiency syndrome (AIDS) or the Epstein-Barr virus. However, CNS lymphoma can also occur in patients with a normal immune system. In such instances, patients are usually over the age of 50.
Because many patients with CNS suffer from immunosuppression, it may be difficult to identify symptoms specific to the CNS lymphoma versus other symptoms related to a compromised immune system. Typical symptoms of a CNS lymphoma include seizure, headache, mental confusion, dizziness, visual impairment, facial muscle weakness, and difficulty swallowing. The team at Piedmont Brain Tumor Center can provide expert diagnosis of possible CNS lymphoma.
The diagnosis begins with a physical and neurological examination and thorough patient history. A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan or both may be necessary to identify and locate the tumor. A biopsy (surgical removal of tumor tissue for analysis) is required for diagnosis, in that CNS lymphoma may resemble toxoplasmosis, a common growth in immunocompromised patients.
Many factors must be considered in the treatment of CNS lymphoma because patients may have comorbid conditions and weakened health. CNS lymphomas often occur deep within the brain, making surgical removal difficult, if not impossible. Radiation and chemotherapy may be considered after surgery, but the optimal course of treatment for CNS lymphoma has not yet been determined. The team at Piedmont Brain Tumor Center works with each individual patient with CNS lymphoma to chart the best and most appropriate treatment for that individual.
Patients with an intact immune system may respond well to radiation treatments, even achieving remission. Highly active anti-retroviral therapy (HAART) prescribed to many HIV and AIDS patients can complicate treatment of CNS lymphoma. The prognosis for immunocompromised patients is worse than for immunocompetent patients. Many new treatments are being studied, including high-dose chemotherapy.
CNS lymphoma is a solid cancerous tumor of the lymphatic cells in the brain. Although it can occur in patients of all ages and conditions, it has been associated with a compromised immune system (AIDS, Epstein-Barr). Diagnosis is usually made by imaging, then biopsy. Surgical removal of the tumor may not always be possible, but tumors may be treated by aggressive chemotherapy or radiation. Since many patients with CNS lymphoma have compromised immune systems, therapy can be complicated. There is no standard therapy, but new treatments are being evaluated.