Primary lymphoma of the brain
Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; PCNSL; Lymphoma - B-cell lymphoma, brainPrimary lymphoma of the brain is cancer of white blood cells that starts in the brain.
Causes
The cause of primary brain lymphoma is not known.
People with a weakened immune system are at high risk for primary lymphoma of the brain. Common causes of a weakened immune system include HIV/AIDS and having had an organ transplant (especially heart transplant).
Primary lymphoma of the brain may be linked to Epstein-Barr Virus (EBV), especially in people with HIV/AIDS. EBV is the virus that causes mononucleosis.
Mononucleosis
Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.
Primary brain lymphoma is more common in people ages 45 to 70. The rate of primary brain lymphoma is rising. Almost 1,500 new patients are diagnosed with primary brain lymphoma every year in the United States.
Symptoms
Symptoms of primary brain lymphoma may include any of the following:
- Changes in speech or vision
- Confusion or hallucinations
Hallucinations
Hallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind.
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Seizures
A seizure is the physical changes in behavior that occurs after an episode of abnormal electrical activity in the brain. The term "seizure" is often ...
ImageRead Article Now Book Mark Article - Headaches, nausea, or vomiting
Headaches
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...
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- Weakness in hands or loss of coordination
- Numbness to hot, cold, and pain
Numbness
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
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- Weight loss
Exams and Tests
The following tests may be done to help diagnose a primary lymphoma of the brain:
- Biopsy of the brain tumor
Biopsy
A biopsy is the removal of a small piece of tissue for laboratory examination.
Read Article Now Book Mark Article - Head CT scan, PET scan or MRI
Head CT scan
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
ImageRead Article Now Book Mark ArticleMRI
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
ImageRead Article Now Book Mark Article - Spinal tap (lumbar puncture)
Spinal tap
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
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Treatment
Primary lymphoma of the brain is often first treated with corticosteroids. These medicines are used to control swelling and improve symptoms. The main treatment is with chemotherapy.
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancer Shrink the cancerPrevent the cancer from...
Younger people may receive high-dose chemotherapy, possibly followed by an autologous stem cell transplant.
Autologous stem cell transplant
A bone marrow transplant is a procedure to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fat...
Radiation therapy of the whole brain may be done after chemotherapy.
Radiation therapy
Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells.
Boosting the immune system, such as in those with HIV/AIDS, may also be tried.
You and your health care provider may need to manage other concerns during your treatment, including:
- Having chemotherapy at home
Having chemotherapy at home
You or your child will be going home from the hospital soon. The health care provider has prescribed medicines or other treatments that you or your ...
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Managing your pets
If you have a weak immune system, having a pet can put you at risk for serious illness from diseases that can spread from animals to humans. Learn w...
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Bleeding problems
Your bone marrow makes cells called platelets. These cells keep you from bleeding too much by helping your blood clot. Chemotherapy, radiation, and...
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Dry mouth
Some cancer treatments and medicines can cause dry mouth. Take good care of your mouth during your cancer treatment. Follow the measures outlined b...
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Eating enough calories
If you are sick or undergoing cancer treatment, you may not feel like eating. But it is important to get enough protein and calories so you do not l...
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Safe eating
When you have cancer, you need good nutrition to help keep your body strong. To do this, you need to be aware of the foods you eat and how you prepa...
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Outlook (Prognosis)
Without treatment, people with primary brain lymphoma survive for less than 6 months. When treated with chemotherapy, half of the patients will be in remission 10 years after being diagnosed. Survival may improve with autologous stem cell transplant.
Possible Complications
Possible complications include:
- Chemotherapy side effects, including low blood counts
- Radiation side effects, including confusion, headaches, nervous system (neurologic) problems, and tissue death
- Return (recurrence) of the lymphoma
References
Baehring JM, Hochberg FH. Primary nervous system tumors in adults. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 74.
Grommes C, DeAngelis LM. Primary CNS lymphoma. J Clin Oncol. 2017;35(21):2410–2418. PMID: 28640701 pubmed.ncbi.nlm.nih.gov/28640701/.
National Cancer Institute website. Primary CNS lymphoma treatment (PDQ) - health professional version. www.cancer.gov/cancertopics/pdq/treatment/primary-CNS-lymphoma/HealthProfessional. Updated May 24, 2019. Accessed February 7, 2020.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): central nervous system cancers. Version 2.2020. www.nccn.org/professionals/physician_gls/pdf/cns.pdf. Updated April 30, 2020. Accessed August 3, 2020.
Brain - illustration
The major areas of the brain have one or more specific functions.
Brain
illustration
MRI of the brain - illustration
An MRI (magnetic resonance imaging) of the brain creates a detailed image of the complex structures in the brain. An MRI can give a three-dimensional depiction of the brain, making location of problems such as tumors or aneuryms more precise.
MRI of the brain
illustration
Brain - illustration
The major areas of the brain have one or more specific functions.
Brain
illustration
MRI of the brain - illustration
An MRI (magnetic resonance imaging) of the brain creates a detailed image of the complex structures in the brain. An MRI can give a three-dimensional depiction of the brain, making location of problems such as tumors or aneuryms more precise.
MRI of the brain
illustration
Review Date: 1/16/2020
Reviewed By: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Surgery, Johnson City Medical Center, TN; St. Alexius Medical Center, Bismarck ND; Department of Neurosurgery Fort Sanders Medical Center, Knoxville TN. Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 08/03/2020.
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