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14 - Central nervous system lymphoma

from Part II - LYMPHOMA SUBTYPES

Published online by Cambridge University Press:  05 March 2010

By
Andrés J. M. Ferreri ,
Lisa M. DeAngelis ,
Andrew Wotherspoon ,
Andreas Rosenwald  and
German Ott
Edited by
Robert Marcus ,
John W. Sweetenham  and
Michael E. Williams
Andrés J. M. Ferreri
Affiliation:
Medical Oncology Unit, Department of Oncology, San Raffaele H. Scientific Institute Via Olgettina 60, 20132, Milan, Italy
Lisa M. DeAngelis
Affiliation:
Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275, York Avenue, New York, NY, 10021, USA
Andrew Wotherspoon
Affiliation:
Department of Histopathology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK
Andreas Rosenwald
Affiliation:
Institute of Pathology, University of Würzburg, Josef-Schneider-Str, 2, Würzburg, 97080, Germany
German Ott
Affiliation:
Institute of Pathology, University of Würzburg, Josef-Schneider-Str, 2, Würzburg, 97080, Germany
Robert Marcus
Affiliation:
Addenbrooke's NHS Foundation Trust, Cambridge
John W. Sweetenham
Affiliation:
Case Western Reserve University, Ohio
Michael E. Williams
Affiliation:
University of Virginia
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Summary

INTRODUCTION

A variety of lymphomas can involve the central nervous system (CNS), at different phases of their evolution, in both immunocompetent and immunocompromised individuals. They represent a heterogeneous group of malignancies, with variable clinical and behavioral characteristics, requiring different therapeutic approaches. In this chapter, the therapeutic management of these malignancies will be analyzed separately in three main entities: primary CNS lymphomas (PCNSL), secondary CNS lymphomas (SCNSL) and other, less common, forms of CNS lymphomas.

PATHOLOGY

The vast majority of CNS lymphomas are diffuse large B-cell lymphomas (DLBCL) that share the morphological and immunophenotypic characteristics similar to those of DLBCLs encountered elsewhere. They may show a perivascular growth pattern. The perivascular infiltrate is associated with increased reticulin fibres and the periphery of areas of involvement frequently shows astrocyte gliosis. Many immunocompromised patients show features similar to Burkitt's lymphoma, while others show a more immunoblastic morphology.

Rare cases of small lymphocytic, lymphoplasmacytic and T-cell lymphoma similar to those seen in tissue outside the CNS have been described. Secondary involvement by lymphoma originating elsewhere is also encountered.

Immunophenotypically CNS lymphomas recapitulate the staining pattern of similar lymphomas encountered outside the CNS. The DLBCLs are positive for CD20 and CD79a with expression of bcl-2 protein. A proportion express CD10 and bcl-6, but they are usually negative for CD5 and CD23. Large B-cell lymphomas in immunocompromised patients frequently contain Epstein–Barr virus (EBV).

Type
Chapter
Information
Lymphoma: Pathology, Diagnosis and Treatment , pp. 200 - 214
Publisher: Cambridge University Press
Print publication year: 2007

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References

Abrey, L. E., Batchelor, T. T., Ferreri, A. J.et al. Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma. J. Clin. Oncol. 23 (2005), 5034–5043.CrossRefGoogle ScholarPubMed
DeAngelis, L. M. and Hormigo, A.Treatment of primary central nervous system lymphoma. Semin. Oncol. 31 (2004), 684–692.CrossRefGoogle ScholarPubMed
DeAngelis, L. M., Seiferheld, W., Schold, S. C.et al. Combination chemotherapy and radiotherapy for primary central nervous system lymphoma: Radiation Therapy Oncology Group Study 93–10. J. Clin. Oncol. 20 (2002), 4643–4648.CrossRefGoogle ScholarPubMed
Ferreri, A. J., Abrey, L. E., Blay, J. Y.et al. Summary statement on primary central nervous system lymphomas from the Eighth International Conference on Malignant Lymphoma, Lugano, Switzerland, June 12 to 15, 2002. J. Clin. Oncol. 21 (2003), 2407–2414.CrossRefGoogle ScholarPubMed
Ferreri, A. J., Reni, M., Pasini, F.et al. A multicenter study of treatment of primary CNS lymphoma. Neurology 58 (2002), 1513–1520.CrossRefGoogle ScholarPubMed
Hoffmann, C., Tabrizian, S., Wolf, E.et al. Survival of AIDS patients with primary central nervous system lymphoma is dramatically improved by HAART-induced immune recovery. AIDS 15 (2001), 2119–2127.CrossRefGoogle ScholarPubMed
Hollender, A., Kvaloy, S., Nome, O.et al. Central nervous system involvement following diagnosis of non-Hodgkin's lymphoma: a risk model. Ann. Oncol. 13 (2002), 1099–1107.CrossRefGoogle ScholarPubMed
Kasamon, Y. L. and Ambinder, R. F.AIDS-related primary central nervous system lymphoma. Hematol. Oncol. Clin. North Am. 19 (2005), 665–687.CrossRefGoogle ScholarPubMed
Besien, K., Forman, A. and Champlin, R.Central nervous system relapse of lymphoid malignancies in adults: the role of high-dose chemotherapy. Ann. Oncol. 8 (1997), 515–524.CrossRefGoogle ScholarPubMed
Besien, K., Ha, C. S., Murphy, S.et al. Risk factors, treatment, and outcome of central nervous system recurrence in adults with intermediate-grade and immunoblastic lymphoma. Blood 91 (1998), 1178–1184.Google ScholarPubMed

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  • Central nervous system lymphoma
    • By Andrés J. M. Ferreri, Medical Oncology Unit, Department of Oncology, San Raffaele H. Scientific Institute Via Olgettina 60, 20132, Milan, Italy, Lisa M. DeAngelis, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275, York Avenue, New York, NY, 10021, USA, Andrew Wotherspoon, Department of Histopathology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK, Andreas Rosenwald, Institute of Pathology, University of Würzburg, Josef-Schneider-Str, 2, Würzburg, 97080, Germany, German Ott, Institute of Pathology, University of Würzburg, Josef-Schneider-Str, 2, Würzburg, 97080, Germany
  • Edited by Robert Marcus, John W. Sweetenham, Case Western Reserve University, Ohio, Michael E. Williams, University of Virginia
  • Book: Lymphoma: Pathology, Diagnosis and Treatment
  • Online publication: 05 March 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511663369.015
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  • Central nervous system lymphoma
    • By Andrés J. M. Ferreri, Medical Oncology Unit, Department of Oncology, San Raffaele H. Scientific Institute Via Olgettina 60, 20132, Milan, Italy, Lisa M. DeAngelis, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275, York Avenue, New York, NY, 10021, USA, Andrew Wotherspoon, Department of Histopathology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK, Andreas Rosenwald, Institute of Pathology, University of Würzburg, Josef-Schneider-Str, 2, Würzburg, 97080, Germany, German Ott, Institute of Pathology, University of Würzburg, Josef-Schneider-Str, 2, Würzburg, 97080, Germany
  • Edited by Robert Marcus, John W. Sweetenham, Case Western Reserve University, Ohio, Michael E. Williams, University of Virginia
  • Book: Lymphoma: Pathology, Diagnosis and Treatment
  • Online publication: 05 March 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511663369.015
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Central nervous system lymphoma
    • By Andrés J. M. Ferreri, Medical Oncology Unit, Department of Oncology, San Raffaele H. Scientific Institute Via Olgettina 60, 20132, Milan, Italy, Lisa M. DeAngelis, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275, York Avenue, New York, NY, 10021, USA, Andrew Wotherspoon, Department of Histopathology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK, Andreas Rosenwald, Institute of Pathology, University of Würzburg, Josef-Schneider-Str, 2, Würzburg, 97080, Germany, German Ott, Institute of Pathology, University of Würzburg, Josef-Schneider-Str, 2, Würzburg, 97080, Germany
  • Edited by Robert Marcus, John W. Sweetenham, Case Western Reserve University, Ohio, Michael E. Williams, University of Virginia
  • Book: Lymphoma: Pathology, Diagnosis and Treatment
  • Online publication: 05 March 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511663369.015
Available formats
×