Journal of Neuro-Oncology

, Volume 25, Issue 1, pp 67–71

Occult systemic Non-Hodgkin's Lymphoma (NHL) in patients initially diagnosed as Primary Central Nervous System Lymphoma (PCNSL): How much staging is enough?

  • B. P. O'Neill
  • R. P. Dinapoli
  • P. J. Kurtin
  • T. M. Habermann
Clinical Study

DOI: 10.1007/BF01054724

Cite this article as:
O'Neill, B.P., Dinapoli, R.P., Kurtin, P.J. et al. J Neuro-Oncol (1995) 25: 67. doi:10.1007/BF01054724

Abstract

Objective

To demonstrate the extent of staging necessary to exclude occult systemic stage IV NHL before making a diagnosis of stage I AE PCNSL.

Background

The diagnosis of PCNSL requires the demonstration of malignant lymphocytes within the CNS (usually by biopsy) and finding no evidence of systemic NHL. Different staging approaches have been recommended, ranging from extensive systemic evaluation (including bone marrow examination) to a more focused approach (abdominal and pelvic CT) to no systemic evaluation. We have employed a staging regimen that included: ophthalmologic evaluation (including slit lamp examination); CT of chest, abdomen, and pelvis; bilateral iliac crest aspirate and biopsy; flow cytometry of circulating lymphocytes; and, in men, testicular ultrasound.

Design/methods

We carried out a retrospective review of 128 patients entered into the Mayo Lymphoma Project data bank (1975–1994).

Results

Between the years 1975 and 1994, five patients (3.9%) were identified who fulfilled criteria for the diagnosis of PCNSL (typical clinical history, pathognomonic neuro-imaging, and histologie proof of NHL in brain tissue) but who had occult systemic NHL on staging (bone marrow 1, abdominal lymph nodes 3), or at autopsy (colon 1). Case histories are presented.

Conclusions

Patients with apparent PCNSL may have systemic NHL. Complete staging is essential to the initial management of patients presenting as PCNSL to exclude systemic stage IV disease.

Key words

CNS lymphoma staging systemic non-Hodgkin's lymphoma 

Copyright information

© Kluwer Academic Publishers 1995

Authors and Affiliations

  • B. P. O'Neill
    • 1
  • R. P. Dinapoli
    • 1
  • P. J. Kurtin
    • 2
  • T. M. Habermann
    • 3
  1. 1.Division of Neuro-Oncology, Department of NeurologyMayo Clinic and FoundationRochesterUSA
  2. 2.Department of Laboratory Medicine and PathologyMayo Clinic and FoundationRochesterUSA
  3. 3.Division of Hematology, and Mayo Comprehensive Cancer CenterMayo Clinic and FoundationRochesterUSA

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