Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지

Primary Central Nervous System Lymphoma in Organ Recipient

  • Hong, Ki-Sun (Department of Neurosurgery, Korea University Medical Center, Ansan Hospital) ;
  • Kim, Sang-Dae (Department of Neurosurgery, Korea University Medical Center, Ansan Hospital) ;
  • Lim, Dong-Jun (Department of Neurosurgery, Korea University Medical Center, Ansan Hospital) ;
  • Park, Jung-Yul (Department of Neurosurgery, Korea University Medical Center, Ansan Hospital)
  • Published : 2005.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

We report a case of primary central nervous system(CNS) lymphoma in an organ recipient. A 33-years-old man who underwent a renal transplantation 3years previously presented with headache and vomiting. In Brain computed tomography scans and magnetic resonance images showed multiple periventricular cystic rim enhancing masses. Pathologic diagnosis by stereotactic biopsy revealed malignant non-Hodgkins B-cell lymphoma. After pathologic confirmation, methotrexate chemotherapy and whole brain radiation therapy were done. Having experienced such a case, the authors strongly recommend to add primary CNS lymphoma as one of the differential diagnoses to brain abscess, metastatic brain tumor and glioblastoma multiforme in cases of multiple ring enhancing periventricular lesions of immunocompromised patient or organ recipient.

Keywords

References

  1. Bataille B, Delwail V, Menet E, Vandermarcq P, Ingrand P, Wager M, et al : Primary intracerebral malignant lymphoma:report of 248 cases. J Neurosurg 92 : 261-266, 2000 https://doi.org/10.3171/jns.2000.92.2.0261
  2. Chamberlain MC, Kormanik PA : AIDS-related central nervous system lymphomas. J Neurooncol 43 : 269-276, 1999 https://doi.org/10.1023/A:1006262720665
  3. Corry J, Smith JG, Wirth A, Quong G, Liew KH : Primary central nervous system lymphoma : age and performance status are more important than treatment modality. Int J Radiat Oncol Biol Phys 41 : 615-620, 1998 https://doi.org/10.1016/S0360-3016(97)00571-3
  4. Eby NL, Grufferman S, Flannelly CM, Schold SC Jr, Vogel FS, Burger PC : Increasing incidence of primary brain lymphoma in the US. Cancer 62 : 2461-2465, 1988 https://doi.org/10.1002/1097-0142(19881201)62:11<2461::AID-CNCR2820621135>3.0.CO;2-M
  5. Glass J, Gruber ML, Cher L, Hochberg FH : Preirradiation methotrexate chemotherapy of primary central nervous system lymphoma : long-term outcome. J Neurosurg 81 : 188-195, 1994 https://doi.org/10.3171/jns.1994.81.2.0188
  6. Guzman R, Barth A, Lovblad KO, El-Koussy M, Weis J, Schroth G, et al : Use of diffusion-weighted magnetic resonance imaging in differentiating purulent brain processes from cystic brain tumors. J Neurosurg 97 : 1101-1107, 2002 https://doi.org/10.3171/jns.2002.97.5.1101
  7. Hiraga S, Arita N, Ohnishi T, Kohmura E, Yamamoto K, Oku Y, et al : Rapid infusion of high-dose methotrexate resulting in enhanced penetration into cerebrospinal fluid and intensified tumor response in primary central nervous system lymphomas. J Neurosurg 91 : 221- 230, 1999 https://doi.org/10.3171/jns.1999.91.2.0221
  8. Hochberg FH, Miller DC : Primary central nervous system lymphoma. J Neurosurg 68 : 835-853, 1988 https://doi.org/10.3171/jns.1988.68.6.0835
  9. Johnson MD, Kinney MC, Scheithauer BW, Briley RJ, Hamilton K, McPherson WF, et al : Primary intracerebral Hodgkin's disease mimicking meningioma : case report. Neurosurgery 47 : 454-457, 2000 https://doi.org/10.1097/00006123-200008000-00038
  10. Lee CH, Lee JK, Kwun BD : Primary central nervous system lymphom a: a report of 33 cases. J Korean Neurosurg Soc 28 : 547-555, 1999
  11. Lee YY, Bruner JM, Van Tassell P, Libshitz HI : Primary central nervous system lymphoma : CT and pathologic correlation. AJR Am J Roentgenol 147 : 747-752, 1986 https://doi.org/10.2214/ajr.147.4.747
  12. Schaefer PW, Grant PE, Ginzalez RG : Diffusion-weighted MR imaging of the brain. Radiology 217 : 331-345, 2000 https://doi.org/10.1148/radiology.217.2.r00nv24331
  13. Tomlinson FH, Kurtin PJ, Suman VJ, Scheithauer BW, Fallon JR, Kelly PJ, et al : Primary intracerebral malignant lymphoma : a clinicopathological study of 89 patients. J Neurosurg 82 : 558-566, 1995 https://doi.org/10.3171/jns.1995.82.4.0558
  14. Urasaki E, Yamada H, Tokimura T, Yokota A : T-cell type primary spinal intramedullary lymphoma associated with human T-cell lymphotropic virus type I after a renal transplant : case report. Neurosurgery 38 : 1036-1039, 1996 https://doi.org/10.1097/00006123-199605000-00036