scholarly journals The changing incidence of primary central nervous system lymphoma is driven primarily by the changing incidence in young and middle-aged men and differs from time trends in systemic diffuse large B-cell non-Hodgkin's lymphoma

2013 ◽  
Vol 88 (12) ◽  
pp. 997-1000 ◽  
Author(s):  
Brian Patrick O'Neill ◽  
Paul A. Decker ◽  
Christina Tieu ◽  
James R. Cerhan
Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4965-4965
Author(s):  
Nancy D Doolittle ◽  
Edward A Neuwelt

Abstract Primary central nervous system lymphoma (PCNSL) is a non-Hodgkin’s lymphoma confined to the craniospinal axis and/or eyes, without evidence of systemic spread. Almost all PCNSL’s are classified as large B-cell lymphoma. A rare variant of PCNSL includes lymphomas of the T-cell phenotype. Until the publication of a large retrospective series of patients (pts) (n = 45) with T-cell PCNSL (Shenkier TN, et al. J Clin Oncol2005;23:2233–2239),only case reports of T-PCNSL and literature reviews were available. The large retrospective series reported that ECOG Performance Status (PS) (0 or 1 versus 2, 3 or 4) at diagnosis was significantly associated with better outcome (Log rank P <.0001), as was primary treatment with high-dose methotrexate (MTX) (yes versus no) (Log rank P = .002). Median survival in the large series was 25 months (95% CI: 11 to 38 months). We reviewed our brain tumor database for pts seen between January 1980 and July 2008. Of 159 pts diagnosed with PCNSL, 3 (2M/1F) had histopathologically confirmed large T-cell phenotype. At diagnosis, the pts’ ages were 10, 23, and 64 years; in each case ECOG PS at diagnosis was 0. Brain parenchyma disease location was periventricular (1 pt), parietal (1 pt), and corpus callosum (1 pt); one pt had both brain and ocular lymphoma. First-line treatment was IA MTX-based chemotherapy with osmotic blood-brain barrier disruption (BBBD), without brain irradiation. The dose of MTX was 2.5 grams/day for 2 consecutive days, every 4 weeks for up to one year. A comprehensive neuropsychological test battery was administered at baseline prior to MTX-based BBBD treatment. Followup neuropsychological testing was conducted within 6 months after the final BBBD treatment. All patients attained CR and are alive 15.8, 8.9 and 1.2 years after diagnosis, with excellent PS and no evidence of disease progression to date. The 3 pts showed stable or improved neuropsychological function in all cognitive domains at follow-up testing. Side effects during BBBD treatment included focal seizures (1 pt) and atrial fibrillation (1 pt). In these 3 cases of T-cell PCNSL, encouraging tumor responses and survival were seen, with stable or improved neurocognitive functioning to date, warranting further investigation of CNS directed therapy in this rare variant of non-Hodgkin’s lymphoma.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Yong Jun Choi ◽  
Jung A. Shin ◽  
Yong Hoon Kim ◽  
Soon Joo Cha ◽  
Joong-Yang Cho ◽  
...  

Neurolymphomatosis (NL) is a rare clinical disease where neoplastic cells invade the cranial nerves and peripheral nerve roots, plexus, or other nerves in patients with hematologic malignancy. Most NL cases are caused by B-cell non-Hodgkin’s lymphoma (NHL). Diagnosis can be made by imaging with positron emission tomography (PET) and magnetic resonance imaging (MRI). We experienced two cases of NL involving the brachial plexus in patients with NHL. One patient, who had NHL with central nervous system (CNS) involvement, experienced complete remission after 8 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy but relapsed into NL of the brachial plexus 5 months later. The other patient, who suffered from primary central nervous system lymphoma (PCNSL), had been undergoing chemoradiotherapy but progressed to NL of the brachial plexus.


Blood ◽  
1996 ◽  
Vol 87 (1) ◽  
pp. 265-272 ◽  
Author(s):  
O Hermine ◽  
C Haioun ◽  
E Lepage ◽  
MF d'Agay ◽  
J Briere ◽  
...  

Abstract Little is known about the expression of bcl-2 protein in intermediate and high grade non-Hodgkin's lymphoma (NHL) and its clinical and prognostic significance. We performed immunohistochemical analysis of bcl-2 expression in tumoral tissue sections of 348 patients with high or intermediate grade NHL. These patients were uniformly treated with adriamycin, cyclophosphamide, vindesine, bleomycin, and prednisone (ACVBP) in the induction phase of the LNH87 protocol. Fifty eight cases were excluded due to inadequate staining. Of the 290 remaining patients, 131 (45%) disclosed homogeneous positivity (high bcl-2 expression) in virtually all tumor cells, whereas 65 (23%) were negative and 94 (32%) exhibited intermediate staining. High bcl-2 expression was more frequent in B-cell NHL (109 of 214, 51%) than in T- cell NHL (6 of 35, 17%) (P = .0004), and was heterogeneously distributed among the different histological subtypes. Further analysis was performed on the 151 patients with diffuse large B-cell lymphoma (centroblastic and immunoblastic) to assess the clinical significance and potential prognostic value of bcl-2 expression in the most frequent and homogeneous immunohistological subgroup. High bcl-2 expression, found in 44% of these patients (67 of 151), was more frequently associated with III-IV stage disease (P = .002). Reduced disease-free survival (DFS) (P < .01) and overall survival (P < .05) were demonstrated in the patients with high bcl-2 expression. Indeed, the 3-year estimates of DFS and overall survival were 60% and 61%, respectively (high bcl-2 expression) versus 82% and 78%, respectively (negative/intermediate bcl-2 expression). A multivariate regression analysis confirmed the independent effect of bcl-2 protein expression on DFS. Thus bcl-2 protein expression, as demonstrated in routinely paraffin-embedded tissue, appears to be predictive of poor DFS, in agreement with the role of bcl-2 in chemotherapy-induced apoptosis. It might be considered as a new independent biologic prognostic parameter, which, especially in diffuse large B-cell NHL, could aid in the identification of patient risk groups.


Rare Tumors ◽  
2015 ◽  
Vol 7 (4) ◽  
pp. 160-162 ◽  
Author(s):  
Pooja Advani ◽  
Jason Starr ◽  
Abhisek Swaika ◽  
Liuyan Jiang ◽  
Yushi Qiu ◽  
...  

Author(s):  
Lakshmi Manjeera Malempati ◽  
Neetha Nandan ◽  
Sagarika Babu

Non-Hodgkin’s lymphoma(NHL) is most commonly encountered during childhood and rarely among the adults. Primary malignant lymphoma in the female genital tract are rare Moreover they present with non-specific symptoms and hence there may be delay in the diagnosis. It is difficult to distinguish this condition from the more common uterine neoplasm such as uterine fibroids or sarcoma. Diffuse large B-cell lymphoma (DLBCL) is most commonly seen among the cases of NHL, contributing to among one third of NHL in the western world. DLBCL is common in elderly population. A 69-year-old postmenopausal woman who came with watery discharge since, 15 days was evaluated clinically and radiologically and was found to have thickened endometrium and enlarged ovaries, for which endometrial biopsy was taken that showed non-secretory endometrium with atrophic changes. Tumor markers found to be normal. TAH+BSO was done and the histopathology showed Non-Hodgkin’s lymphoma, diffuse large B cell type of the endometrium and both ovaries which was confirmed by immune histochemical marker study. PET-CT was done that showed metabolically active para aortic and common iliac lymph nodes thereby she was diagnosed with stage II (Ann Arbor Staging) non-Hodgkin’s lymphoma, hence she received 6 cycles of R-CHOP. As evident in our case, non-Hodgkin’s Lymphoma of the endometrium and the ovaries being an extremely rare condition, high-degree of suspicion is required for its prompt diagnosis and treatment.


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