title: Central nervous system lymphoma: patterns of incidence in Indian population and effect of steroids on stereotactic biopsy yield.
abstract: BACKGROUND
  Epidemiology of primary central nervous system lymphoma (PCNSL) world-wide shows an increase in incidence linked to human immunodeficiency virus (HIV) pandemic.
  
  
  METHODS
  This retrospective review of case records analyzed the trends of hospital-based incidence of PCNSL over two decades (1991-2010), relation to immune status and effect of steroids on yield of stereotactic biopsy (STB).
  
  
  RESULTS
  A total of 76 cases of PCNSL were diagnosed over a period of two decades. Incidence of lymphomas amongst all biopsied lesions showed a gradual increase from 0.18% at the beginning of study period to 0.41% at the end of study period. Only 8.6% (3 of 35 tested) of the PCNSL patients were positive for HIV. The mean age of patients with HIV infection (31.3 ± 3.5 years) was significantly lower compared with those without HIV infection (44.7 ± 10.9 years) (P = 0.033). Diagnosis was obtained by open biopsy in 32 patients (42.1%) and STB in 44 patients (57.9%). Open biopsy yielded a histological confirmation of PCNSL in all cases. Among those who underwent STB, the incidence of negative biopsy with short duration of steroids (≤ 1 week) was 33.3% and increased to 57.1% with increasing duration of steroid treatment (>1 week).
  
  
  CONCLUSIONS
  This study documented an increase in hospital based incidence of PCNSL in our institute, independent of HIV association. Steroid intake administration for more than a week prior to biopsy adversely affected the yield of STB in PCNSL.
authors.forename: N
authors.initials: N
authors.lastname: Manoj
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: A
authors.initials: A
authors.lastname: Arivazhagan
authors.forename: Anita
authors.initials: A
authors.lastname: Mahadevan
authors.forename: Dhananjaya I
authors.initials: DI
authors.lastname: Bhat
authors.forename: H R
authors.initials: HR
authors.lastname: Arvinda
authors.forename: B Indira
authors.initials: BI
authors.lastname: Devi
authors.forename: S
authors.initials: S
authors.lastname: Sampath
authors.forename: B A
authors.initials: BA
authors.lastname: Chandramouli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008223:Lymphoma / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D013256:Steroids / Q000627:therapeutic use*; D013997:Time Factors; D055815:Young Adult
chemical_list: D013256:Steroids