Letters to the Editor
References 1. Gerstner E, Batcheolar T. Primary CNS lymphoma. Expert Rev Anticancer Ther 2007;7:689‑700. 2. Schlegel U, Schmidt‑Wolf IG, Deckert M. Primary CNS lymphoma: Clinical presentation, pathological classification, molecular pathogenesis and treatment. J Neurol Sci 2000;181:1‑12. 3. Cheatle JT, Aizenberg MR, Weinberg JS, Surdell DL. Atypical presentation of primary central nervous system non‑Hodgkin lymphoma in immunocompetent young adults. World Neurosurg 2013;79:593.e9‑13. 4. Ilker A, Aykut B, Muge H, Ibrahim HM, Ulkua OB, Tugba D, et al. Primary brain T‑cell lymphoma during pregnancy. J Pak Med Assoc 2012;62:394‑6. 5. Kim IY, Jung S, Jung TY, Kang SS, Choi C. Primary central nervous system lymphoma presenting as an acute massive intracerebral hemorrhage: Case report with immunohistochemical study. Surg Neurol 2008;70:308‑11. 6. Matsuyama J, Ichikawa M, Oikawa T, Sato T, Kishida Y, Oda K, et al. Primary CNS lymphoma arising in the region of the optic nerve presenting as loss of vision: 2 case reports, including a patient with a massive intracerebral hemorrhage. Brain Tumor Pathol 2013. 7. Weller M, Martus P, Roth P, Thiel E, Korfel A; German PCNSL Study Group. Surgery for primary CNS lymphoma? Challenging a paradigm. Neuro Oncol 2012;14:1481‑4.
with or without radiotherapy, and surgery is mainly limited to tissue diagnosis, due to its diffusely infiltrative nature. However, in some cases, such as a huge tumor with impending herniation or CNS lymphoma cases with intratumoral hemorrhage, emergency surgery for mass reduction is required. Intracerebral hemorrhage in primary CNS lymphoma is rare, but higher vascular endothelial growth factor (VEGF) immune reactivity in hemorrhagic cases is observed compared to non‑hemorrhagic cases.[2‑5] Also, serum elevation of VEGF levels are predictors of poor prognosis. In the previously reported cases of intratumoral hemorrhage in primary CNS lymphomas, emergent craniotomy and removal of mass reduction was performed. Although impending herniation of primary CNS lymphomas is rare, a mass reduction surgery should sometimes be considered in such unique cases.
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Junko Matsuyama
Website: www.ruralneuropractice.com
Department of Neurosurgery, Fukushima Medical University,1 Hikarigaoka, Fukushima, 960‑1295, Japan Address for correspondence: Dr. Junko Matsuyama, Department of Neurosurgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960‑1295, Japan. E‑mail: [email protected]
DOI: 10.4103/0976-3147.127925
Emergent management with favorable outcome of an unusual presentation of a primary central nervous system lymphoma in an immunocompetent patient Sir, This article is a report of a case with primary central nervous system (CNS) lymphoma, with impending brain herniation due to a huge mass, and surgical reduction was effective in obtaining neurological improvement.[1] Usually the standard therapy for primary CNS malignant lymphoma, at present, is high‑dose methotrexate therapy 90
References 1.
2. 3. 4. 5.
Rao AS, Dadlani R, Ghosal N, Hegde AS. Emergent management with favorable outcome of an unusual presentation of a primary CNS lymphoma in an immunocompetent patient. J Neurosci Rural Pract 2014;5:88-90. Fukui MB, Livstone BJ, Meltzer CC, Hamilton RL. Emorrhage He Hemorrhagic presentation of untreated primary CNS lymphoma in a patient with AIDS. AJR Am J Roentgenol 1998;170:1114‑5. Rubenstein J, Fischbein N, Aldape K, Burton E, Shuman M. Hemorrhage and VEGF expression in a case of primary CNS lymphoma. J Neurooncol 2002;58:53‑6. Kim IY, Jung S, Jung TY, Kang SS, Choi C. Primary central nervous system lymphoma presenting as an acute massive intracerebral hemorrhage: Case report with immunohistochemical study. Surg Neurol 2008;70:308‑11. Matsuyama J, Ichikawa M, Oikawa T, Sato T, Kishida Y, Oda K, et al. Primary CNS lymphoma arising in the region of the optic nerve presenting as loss of vision: 2 case reports, including a patient with a massive intracerebral hemorrhage. Brain Tumor Pathol 2013 [Epub ahead of print].
Access this article online Quick Response Code:
Website: www.ruralneuropractice.com
DOI: 10.4103/0976-3147.127926
Journal of Neurosciences in Rural Practice | January - March 2014 | Vol 5 | Issue 1
Copyright of Journal of Neurosciences in Rural Practice is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
References 1. Gerstner E, Batcheolar T. Primary CNS lymphoma. Expert Rev Anticancer Ther 2007;7:689‑700. 2. Schlegel U, Schmidt‑Wolf IG, Deckert M. Primary CNS lymphoma: Clinical presentation, pathological classification, molecular pathogenesis and treatment. J Neurol Sci 2000;181:1‑12. 3. Cheatle JT, Aizenberg MR, Weinberg JS, Surdell DL. Atypical presentation of primary central nervous system non‑Hodgkin lymphoma in immunocompetent young adults. World Neurosurg 2013;79:593.e9‑13. 4. Ilker A, Aykut B, Muge H, Ibrahim HM, Ulkua OB, Tugba D, et al. Primary brain T‑cell lymphoma during pregnancy. J Pak Med Assoc 2012;62:394‑6. 5. Kim IY, Jung S, Jung TY, Kang SS, Choi C. Primary central nervous system lymphoma presenting as an acute massive intracerebral hemorrhage: Case report with immunohistochemical study. Surg Neurol 2008;70:308‑11. 6. Matsuyama J, Ichikawa M, Oikawa T, Sato T, Kishida Y, Oda K, et al. Primary CNS lymphoma arising in the region of the optic nerve presenting as loss of vision: 2 case reports, including a patient with a massive intracerebral hemorrhage. Brain Tumor Pathol 2013. 7. Weller M, Martus P, Roth P, Thiel E, Korfel A; German PCNSL Study Group. Surgery for primary CNS lymphoma? Challenging a paradigm. Neuro Oncol 2012;14:1481‑4.
with or without radiotherapy, and surgery is mainly limited to tissue diagnosis, due to its diffusely infiltrative nature. However, in some cases, such as a huge tumor with impending herniation or CNS lymphoma cases with intratumoral hemorrhage, emergency surgery for mass reduction is required. Intracerebral hemorrhage in primary CNS lymphoma is rare, but higher vascular endothelial growth factor (VEGF) immune reactivity in hemorrhagic cases is observed compared to non‑hemorrhagic cases.[2‑5] Also, serum elevation of VEGF levels are predictors of poor prognosis. In the previously reported cases of intratumoral hemorrhage in primary CNS lymphomas, emergent craniotomy and removal of mass reduction was performed. Although impending herniation of primary CNS lymphomas is rare, a mass reduction surgery should sometimes be considered in such unique cases.
Access this article online Quick Response Code:
Junko Matsuyama
Website: www.ruralneuropractice.com
Department of Neurosurgery, Fukushima Medical University,1 Hikarigaoka, Fukushima, 960‑1295, Japan Address for correspondence: Dr. Junko Matsuyama, Department of Neurosurgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960‑1295, Japan. E‑mail: [email protected]
DOI: 10.4103/0976-3147.127925
Emergent management with favorable outcome of an unusual presentation of a primary central nervous system lymphoma in an immunocompetent patient Sir, This article is a report of a case with primary central nervous system (CNS) lymphoma, with impending brain herniation due to a huge mass, and surgical reduction was effective in obtaining neurological improvement.[1] Usually the standard therapy for primary CNS malignant lymphoma, at present, is high‑dose methotrexate therapy 90
References 1.
2. 3. 4. 5.
Rao AS, Dadlani R, Ghosal N, Hegde AS. Emergent management with favorable outcome of an unusual presentation of a primary CNS lymphoma in an immunocompetent patient. J Neurosci Rural Pract 2014;5:88-90. Fukui MB, Livstone BJ, Meltzer CC, Hamilton RL. Emorrhage He Hemorrhagic presentation of untreated primary CNS lymphoma in a patient with AIDS. AJR Am J Roentgenol 1998;170:1114‑5. Rubenstein J, Fischbein N, Aldape K, Burton E, Shuman M. Hemorrhage and VEGF expression in a case of primary CNS lymphoma. J Neurooncol 2002;58:53‑6. Kim IY, Jung S, Jung TY, Kang SS, Choi C. Primary central nervous system lymphoma presenting as an acute massive intracerebral hemorrhage: Case report with immunohistochemical study. Surg Neurol 2008;70:308‑11. Matsuyama J, Ichikawa M, Oikawa T, Sato T, Kishida Y, Oda K, et al. Primary CNS lymphoma arising in the region of the optic nerve presenting as loss of vision: 2 case reports, including a patient with a massive intracerebral hemorrhage. Brain Tumor Pathol 2013 [Epub ahead of print].
Access this article online Quick Response Code:
Website: www.ruralneuropractice.com
DOI: 10.4103/0976-3147.127926
Journal of Neurosciences in Rural Practice | January - March 2014 | Vol 5 | Issue 1
Copyright of Journal of Neurosciences in Rural Practice is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
