Health Encyclopedia

Primary lymphoma of the brain

Definition

Primary lymphoma of the brain is cancer that started in the brain.

Alternative Names

Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain

Causes, incidence, and risk factors

The cause of primary brain lymphoma is unknown, but it is more common in people between the ages of 45 and 70. Patients who are immunocompromised, such those with HIV or organ transplants, especially heart transplants, are at greater risk for primary lymphoma of the brain. In immunocompromised patients, the lymphoma is linked to Epstein Barr Virus (EBV) infection.

The incidence is rising, but primary brain lymphoma is still relatively rare.

Symptoms

Personality changes
Confusion
Changes in speech
Changes in vision
Weakness in hands
Numbness to hot, cold, and pain
Headaches
Seizures
Hallucinations

Signs and tests

The following tests may be performed to help diagnose a primary lymphoma of the brain:

Biopsy of the brain -- shows lymphoma
Head CT scan -- shows a brain lesion
CSF total protein -- high
CSF cell count -- shows increased white blood cells or lymphoma cells

Treatment

The initial treatment is usually with corticosteroids. However, chemotherapy increases survival in many individuals up to 3 - 4 years, or longer. The chemotherapy is primarily high-dose methotrexate given intravenously or via the spinal cord.

Treatment of immunocompromised patients is not as successful, but is improving.

Radiation therapy used to be the main treatment for this lymphoma, but now is usually reserved for treating those patients in whom chemotherapy is not successful.

Treatment with multiple therapies (combination therapy) is common.

Expectations (prognosis)

The survival of untreated primary brain lymphoma is under 2 months. Treated with chemotherapy, patients often survive 3-4 years or more. About 40% of patients are alive at 5 years. In general, older patients have a worse outlook than younger patients.

Complications

Possible complications include:

Radiation side effects, including confusion, headaches, neurologic problems, and tissue death
Chemotherapy side effects, including low blood counts
Recurrence of the lymphoma

References

National Cancer Institute. Adult hodgkin lymphoma treatment (PDQ). 2008. Accessed June 10, 2008.

Review Date:6/10/2008
Reviewed By:James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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