Abstract
In patients with acquired immunodeficiency syndrome (AIDS), primary central nervous system lymphoma (PCNSL) is now the most common noninfectious intracranial mass lesion and the fourth leading cause of death. Most cases of PCNSL are B-cell in origin and are only rarely of T-cell origin. We report the first complete clinical description of T-cell PCNSL in a patient with AIDS. This patient underwent stereotactic biopsy of a cerebellar lesion that demonstrated T-cell lymphoma by immunohistochemical staining. The patient died from opportunistic infection after partial radiation therapy. Complete autopsy revealed no evidence of residual T-cell lymphoma. The authors compare T-cell PCNSL in patients with and without AIDS, and discuss differences betweenT-cell and B-cell PCNSL. In conclusion, T-cell PCNSL can occur in patients with AIDS. The tumor is often located infratentoriallyand appears to be radiosensitive. However, the patient's survival is short because death is usually caused by opportunistic infection rather than mass effect from lymphoma.
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References
Ling SM, Roach M, Larson DA, Wara WM: Radiotherapy of primary central nervous system lymphoma in patients with and without human immunodeficiency virus. Canc 73: 2570–2582, 1994
Goldstein JD, Dickson DW, Moser FG, Hirschfeld AD, Freeman K, Lena JF, Kaplan B, Davis L: Primary central nervous system lymphoma in acquired immunodeficiency syndrome. Canc 67: 2756–2765, 1991
Remick SC, Diamond C, Migliozzi JA, Solis O, Wagner H, Haase RF, Ruckdeschel JC: Primary central nervous system lymphoma in patients with and without the acquired immune deficiency syndrome. Med 69: 345–360, 1990
Anson JA, Glick RP, Reyes M: Diagnostic accuracy of AIDS-related CNS lesions. Surg Neurol 37: 432–440, 1992
Chappell ET, Guthrie BL, Orenstein J: The role of stereotactic biopsy in the management of HIV-related focal brain lesions. Neurosurgery 30: 825–829, 1992
Chin LS, Namiki T, Chandrasoma P, Zee CZ, Apuzzo JLJ: Experience with image-directed stereotactic biopsy of CNS lesions in AIDS (abstract). Presented at the 58th Annual Meeting of the American Association of Neurological Surgeons. Nashville, TN, May 1990
Levy RM, Bredesen DE: Central nervous system dysfunction in acquired immunodeficiency syndrome. J AIDS 1: 41–64, 1988
Levy RM, Bredesen DE, Rosenblum ML: Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): Experience at UCSF and review of the literature. J Neurosurg 62: 475–495, 1985
Levy RM, Russell E, Yungbluth M, Hidvegi DF, Brody BA, Dal Canto MC: The efficacy of image-guided stereotactic brain biopsy in neurologically symptomatic acquired immunodeficiency syndrome patients. Neurosurgery 30: 186–192, 1992
Marks WJ, McArthur JC, Royal W, Kumar AJ, Erozan Y, Herman C, Uematsu S: Intracranial mass lesions in AIDS: Diagnosis and response to therapy. Neurol 39 (suppl 1): 380, 1989
Grant JW, Isaacson PG: Primary central nervous system lymphoma. Brain Pathol 2: 97–109, 1992
Jellinger KA, Paulus W: Primary central nervous system lymphomas-an update. J Canc Res Clin Oncol 119: 7–27, 1992
McCue MP, Sandrock AW, Lee JM, Harris NL: Primary T-cell lymphoma of the brainstem. Neurol 43: 377–381, 1993
Rao C, Wrzolek M, Koszlowski PB: Primary T cell central nervous system lymphoma in AIDS (abstract). J Neuropathol Exp Neurol 48: 302, 1989
Snider WD, Simpson DM, Aronyk KE: Primary lymphoma of the nervous system associated with AIDS (letter). N Engl J Med 308: 45, 1983
Grant JW, vonDeimling A: Primary T-cell lymphoma of the central nervous system. Arch Pathol Lab Med 114: 24–27, 1990
Kanavaros P, Mikol J, Nemeth J, Galian A, Vaunaize J, Morinet F, Thurel C: Primary T-cell malignant lymphoma of the central nervous system. Histological, immunohistochemical and ultrastructural study of a case. Pathol Res Pract 189: 93–101, 1993
Morgello S, Maiesse K, Petito CK: T-cell lymphoma in the central nervous system: clinical and pathological features. Neurol 39: 1190–1196, 1989
Adams JH, Howatson AG: Cerebral lymphomas: Review of 70 cases. J Clin Pathol 43: 544–547, 1990
Feiden W, Bise K, Steude U: Diagnosis of primary cerebral lymphoma with particular reference to CT-guided stereotactic biopsy. Virchows Arch A Pathol Anat Histopathol 417: 21–28, 1990
Nishiyama A, Saito T, Abe S, Kumanishi T: An immunohistochemical anlaysis of T cells in primary B cell malignant lymphoma of the brain. Acta Neuropathol 79: 27–29, 1989
Hacker SM, Knight BP, Lunde NM, Gratiot-Deans J, Sandler H, Leichtman AB: A primary CNS T cell lymphoma in a renal transplant patient. Transplant 53: 691–692, 1992
Nelson DF, Martz KL, Bonner H, Nelson JS, Newall J, Kerman HD, Thomson JW, Murray KJ: Non-Hodgkin's lymphoma of the brain: can high dose, large volume radiation therapy improve survival? Report on a prospective trial by the Radiation Therapy Oncology Group (RTOG): RTOG 8315. Int J Radiat Oncol Biol Phys 23: 9–17, 1992
Fine HA, Mayer RJ: Primary central nervous system lymphoma. Ann Intern Med 119: 1093–1104, 1993
Hardwidge C, Diengdoh JV, Husband D, Nash JR: Primary cerebral lymphoma-a clinicopathological study. Clin Neuropathol 9: 217–223, 1990
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Bindal, A.K., Blisard, K.S., Melin-Aldama, H. et al. Primary T-cell lymphoma of the brain in acquired immunodeficiency syndrome: Case report. J Neurooncol 31, 267–271 (1997). https://doi.org/10.1023/A:1005769406324
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DOI: https://doi.org/10.1023/A:1005769406324