J Korean Neurol Assoc.  1995 Dec;13(4):954-964.

Primary CNS Lymphoma in Immunocompetent Patients A Clinical and Pathological Study

• Kim GM
• Jeon BS
• Yoon BW
• Lee SB
• Chi JG

Abstract

To characterize the clinical manifestations, and histologic features of CNS lymphoma in immunocompetent patients, we collected 15 cases of biopsy proven primary CNS lymphoma. Evidences of systemic lymphoma, HIV infection, and immune-compromising diseases were absent at the diagnosis. Brain MRI had been taken before radiation or chemotherapy, and pathologic specimens were classified according to working formulation and some cases underwent immunological marker studies. Mean duration of illness was 1. 8 months, mild CSF protein elevation(mean=58mg%) was observed in 5 of 6 patients, CSF cytology was positive in 2 of 7, and the recurrence rate was 69%. In MR imaging, tumor size was variable, and 5 patients had multiple lesions at diagnosis. All patients showed homogeneous(87%) or heterogeneous(13%) gadolinium enhancement, and secondary tumor change was shown in I case. The tumor had high tendency in abutting on CSF space(60%), and there was no relationship between histologic types and MR imaging I s. Classified by working formulation, the intermediate grade lymphomas(diffuse large cell and small cell cleaved types) were 14 out of 15(93%) and I showed low grade(small lymphocytic). B-cell lymphoma was 8 out of 9, and T-cell was only 1. As compared with the previous reported pathologic data of AIDS-related CNS lymphoma, the histology of lymphoma in immunocompetent patients were less malignant than those related to AIDS and immune-compromised patients.

MeSH Terms

Biopsy
Brain
Diagnosis
Drug Therapy
Gadolinium
HIV Infections
Humans
Lymphoma*
Lymphoma, B-Cell
Magnetic Resonance Imaging
Recurrence
T-Lymphocytes
Gadolinium