Clinical and diagnostic considerations in primary central nervous system lymphoma

Tracy Batchelor, Edward Neuwelt, Daphne L. Wang, R. Gilberto Gonzalez

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The clinical presentation and radiographic appearance of PCNSL differ in immunocompetent and immunocompromised patients and are non-specific for both. A cranial MRI revealing a homogenously enhancing, single lesion in a periventricular location is suggestive of PCNSL in the immunocompetent patient. After neuroimaging suggestive of PCNSL, definitive diagnosis should be established by analysis of CSF, vitreous fluid, or biopsy specimen. Brain biopsy remains the gold standard for PCNSL diagnosis in all patients. At the time of diagnosis, the patient should undergo an extent of disease evaluation as recommended by the International PCNSL Collaborative Group (IPCG). This evaluation includes a physical examination; ophthalmological evaluation with a slit-lamp examination; body CT scans; contrast-enhanced brain MRI; lumbar puncture, if safe; bone marrow biopsy; serum LDH; and HIV serology. Testicular ultrasound, for men, and body FDG-PET should also be considered. Baseline and serial evaluation of cognitive function is critical in this patient population, as both the tumor and anti-tumor therapy are capable of negatively impacting neuropsychological function. Prognostic scoring systems are emerging for the PCNSL patient population.

Original languageEnglish (US)
Title of host publicationLymphoma and Leukemia of the Nervous System
PublisherSpringer New York
Pages113-128
Number of pages16
ISBN (Print)9781441976680, 9781441976673
DOIs
StatePublished - Jan 1 2012

Fingerprint

Lymphoma
Central Nervous System
Biopsy
Spinal Puncture
Brain
Immunocompromised Host
Serology
Neuroimaging
Cognition
Population
Physical Examination
Neoplasms
Bone Marrow
HIV
Serum
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Batchelor, T., Neuwelt, E., Wang, D. L., & Gonzalez, R. G. (2012). Clinical and diagnostic considerations in primary central nervous system lymphoma. In Lymphoma and Leukemia of the Nervous System (pp. 113-128). Springer New York. https://doi.org/10.1007/9781441976680_6

Clinical and diagnostic considerations in primary central nervous system lymphoma. / Batchelor, Tracy; Neuwelt, Edward; Wang, Daphne L.; Gonzalez, R. Gilberto.

Lymphoma and Leukemia of the Nervous System. Springer New York, 2012. p. 113-128.

Research output: Chapter in Book/Report/Conference proceedingChapter

Batchelor, T, Neuwelt, E, Wang, DL & Gonzalez, RG 2012, Clinical and diagnostic considerations in primary central nervous system lymphoma. in Lymphoma and Leukemia of the Nervous System. Springer New York, pp. 113-128. https://doi.org/10.1007/9781441976680_6
Batchelor T, Neuwelt E, Wang DL, Gonzalez RG. Clinical and diagnostic considerations in primary central nervous system lymphoma. In Lymphoma and Leukemia of the Nervous System. Springer New York. 2012. p. 113-128 https://doi.org/10.1007/9781441976680_6
Batchelor, Tracy ; Neuwelt, Edward ; Wang, Daphne L. ; Gonzalez, R. Gilberto. / Clinical and diagnostic considerations in primary central nervous system lymphoma. Lymphoma and Leukemia of the Nervous System. Springer New York, 2012. pp. 113-128
@inbook{2b05eb2c16814d02a744ff94d0386ada,
title = "Clinical and diagnostic considerations in primary central nervous system lymphoma",
abstract = "The clinical presentation and radiographic appearance of PCNSL differ in immunocompetent and immunocompromised patients and are non-specific for both. A cranial MRI revealing a homogenously enhancing, single lesion in a periventricular location is suggestive of PCNSL in the immunocompetent patient. After neuroimaging suggestive of PCNSL, definitive diagnosis should be established by analysis of CSF, vitreous fluid, or biopsy specimen. Brain biopsy remains the gold standard for PCNSL diagnosis in all patients. At the time of diagnosis, the patient should undergo an extent of disease evaluation as recommended by the International PCNSL Collaborative Group (IPCG). This evaluation includes a physical examination; ophthalmological evaluation with a slit-lamp examination; body CT scans; contrast-enhanced brain MRI; lumbar puncture, if safe; bone marrow biopsy; serum LDH; and HIV serology. Testicular ultrasound, for men, and body FDG-PET should also be considered. Baseline and serial evaluation of cognitive function is critical in this patient population, as both the tumor and anti-tumor therapy are capable of negatively impacting neuropsychological function. Prognostic scoring systems are emerging for the PCNSL patient population.",
author = "Tracy Batchelor and Edward Neuwelt and Wang, {Daphne L.} and Gonzalez, {R. Gilberto}",
year = "2012",
month = "1",
day = "1",
doi = "10.1007/9781441976680_6",
language = "English (US)",
isbn = "9781441976680",
pages = "113--128",
booktitle = "Lymphoma and Leukemia of the Nervous System",
publisher = "Springer New York",

}

TY - CHAP

T1 - Clinical and diagnostic considerations in primary central nervous system lymphoma

AU - Batchelor, Tracy

AU - Neuwelt, Edward

AU - Wang, Daphne L.

AU - Gonzalez, R. Gilberto

PY - 2012/1/1

Y1 - 2012/1/1

N2 - The clinical presentation and radiographic appearance of PCNSL differ in immunocompetent and immunocompromised patients and are non-specific for both. A cranial MRI revealing a homogenously enhancing, single lesion in a periventricular location is suggestive of PCNSL in the immunocompetent patient. After neuroimaging suggestive of PCNSL, definitive diagnosis should be established by analysis of CSF, vitreous fluid, or biopsy specimen. Brain biopsy remains the gold standard for PCNSL diagnosis in all patients. At the time of diagnosis, the patient should undergo an extent of disease evaluation as recommended by the International PCNSL Collaborative Group (IPCG). This evaluation includes a physical examination; ophthalmological evaluation with a slit-lamp examination; body CT scans; contrast-enhanced brain MRI; lumbar puncture, if safe; bone marrow biopsy; serum LDH; and HIV serology. Testicular ultrasound, for men, and body FDG-PET should also be considered. Baseline and serial evaluation of cognitive function is critical in this patient population, as both the tumor and anti-tumor therapy are capable of negatively impacting neuropsychological function. Prognostic scoring systems are emerging for the PCNSL patient population.

AB - The clinical presentation and radiographic appearance of PCNSL differ in immunocompetent and immunocompromised patients and are non-specific for both. A cranial MRI revealing a homogenously enhancing, single lesion in a periventricular location is suggestive of PCNSL in the immunocompetent patient. After neuroimaging suggestive of PCNSL, definitive diagnosis should be established by analysis of CSF, vitreous fluid, or biopsy specimen. Brain biopsy remains the gold standard for PCNSL diagnosis in all patients. At the time of diagnosis, the patient should undergo an extent of disease evaluation as recommended by the International PCNSL Collaborative Group (IPCG). This evaluation includes a physical examination; ophthalmological evaluation with a slit-lamp examination; body CT scans; contrast-enhanced brain MRI; lumbar puncture, if safe; bone marrow biopsy; serum LDH; and HIV serology. Testicular ultrasound, for men, and body FDG-PET should also be considered. Baseline and serial evaluation of cognitive function is critical in this patient population, as both the tumor and anti-tumor therapy are capable of negatively impacting neuropsychological function. Prognostic scoring systems are emerging for the PCNSL patient population.

UR - http://www.scopus.com/inward/record.url?scp=84955092224&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84955092224&partnerID=8YFLogxK

U2 - 10.1007/9781441976680_6

DO - 10.1007/9781441976680_6

M3 - Chapter

AN - SCOPUS:84955092224

SN - 9781441976680

SN - 9781441976673

SP - 113

EP - 128

BT - Lymphoma and Leukemia of the Nervous System

PB - Springer New York

ER -