A central nervous system lymphoma (CNS lymphoma) is a cancer of the lymphatic tissues of the brain, the spinal cord, the meninges or membranes covering the brain (called meningeal lymphoma), and can extend into the eye (known as intraocular lymphoma). It is more commonly found in patients in their 60s or 70s, and sometimes is linked to an immunosuppressed condition.
When the lymphoma originates in the central nervous system it is called primary CNS lymphoma, and if it begins somewhere else and then extends into the CNS system, it is known as a secondary CNS lymphoma.
The majority of CNS lymphomas are of B-cell origins, but the range does include other cells such as T-cells and microglial cells.
A primary brain lymphoma is rare, arising from lymphatic cells found within the brain. They represent less than 1 percent of all central nervous system (CNS) tumors. A brain lymphoma, or cerebral lymphoma, can occur at any age, but is more common in people ages 45 – 70. Patients who have a weakened immune system are at greater risk.
Brain lymphoma spreads by infiltration of the cerebrospinal fluid and seeding within the central nervous system. In rare cases (fewer than 10 percent), the disease spreads to other organs, bones and soft tissues. Most central nervous system lymphomas are diffuse large B-cell lymphomas.
Having an impaired immune system can increase your risk of developing CNS lymphoma. Conditions such as immunosuppression of the system after a transplant to reduce organ rejection or acquired immune deficiency syndrome (AIDS) have been linked to higher rates of CNS Lymphoma.
Symptoms of central nervous system lymphoma depend, in part, on where the cancer is located. If the lymphoma is within the brain or meninges, symptoms can include
Other issues that may present with time:
If the cancerous lymphatic cells block the flow of cerebrospinal fluid, the pressure inside the cranium can increase causing more critical symptoms such as sleepiness and a lack of responsiveness, in addition to vomiting and headaches.
Compression on the spinal cord from a tumor can bring about other symptoms:
Intraocular lymphoma, lymphoma that has spread to the eyes, may present symptoms of blurred vision and floaters—shadows and spots that float in the field of vision.
Physicians have a number of tools to help make an accurate diagnosis:
Steroids are given to reduce inflammation of the tissues around the lymphoma, especially if there is heightened intracranial pressure due to slowed or arrested cerebrospinal fluid (CSF) flow. Generally, if primary CNS lymphoma is suspected, steroids won’t be introduced until after a stereotactic brain biopsy.
A ventriculoperitoneal shunt may also be recommended to help relieve intracranial pressure from CSF accumulation.
Chemotherapy is the dominant treatment for CNS lymphoma. Intrathecal chemotherapy injects the medication directly into the space in the spinal cord. An Ommaya reservoir may be recommended to avoid needing numerous lumbar punctures to deliver intrathecal chemotherapy.
Corticosteroids may be given to reduce swelling and provide symptom relief.
Chemotherapy, which penetrates the blood-brain barrier and reaches the fluid surrounding the brain, might be given intravenously or intrathecally (directly into the fluid surrounding the spinal cord.)
Whole-brain radiation may be used if the lymphoma is resistant to chemotherapy.
Neurosurgery. Some larger well-defined lesions that are closer to the surface of the brain may be operable.
Autologous stem cell transplant uses the patient’s own stem cells for treatment.
Find out what revolutionary treatment options are available to you in the New York area. Contact one of our specialists at The Long Island Brain Tumor Center, NY.
Radiotherapy such as gamma knife radiosurgery may be especially advantageous for those with recurrent CNS lymphoma.
Stem cell transplants are a new strategy being tested in clinical trials. NSPC Brain & Spine Surgery (NSPC) (NSPC) participates in the latest and most state-of-the-art treatment options to give you the best choice in care options.
The CNS lymphoma specialists at NSPC’s Long Island Brain Tumor Center offer expert consultations and treatment. The New York area offices mean you get top-notch care from leading physicians, close to home.
Without treatment, patients with primary brain lymphoma may survive for less than 2 months. Patients who are treated with chemotherapy often survive 3 – 4 years or more, depending on whether the tumor stays in remission. About 40% of patients are alive at 5 years. Survival may improve with the increased use of autologous stem cell transplants.
Many factors including the health, age and condition of the immune system of the patient can affect treatment choices. Along with medical standard-of-care treatments, NSPC participates in a number of clinical trials, to offer you the most advanced treatment options available.
Long Island Brain and Spine Tumor Center
NSPC provides state-of-the-art treatment of benign and malignant brain and spine tumors, using minimally invasive procedures like Gamma Knife®, Novalis TX™, and CyberKnife® rather than major surgery whenever appropriate. Our physicians also perform experienced pediatric neurosurgery — they give personalized, individual attention combined with knowledge and experience to take on the most challenging of cases.
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