title: [Retrospective study of 48 cases of primary central nervous system lymphoma].
abstract: Primary central nervous system lymphoma (PCNSL) is an infrequent form of non-Hodgkin lymphoma restricted to the CNS. More than 90% are type B and mainly affect patients aged 50-70 years. Immunodeficiency is the most important risk factor. The aim of our study was to evaluate the immune status, clinical presentation and findings in complementary studies of PCNSL patients. A retrospective analysis of 48 cases treated in our center between January 1992 and May 2015 was performed. Median age at diagnosis was 61 years (range 25-84); with male predominance (2.1:1). Forty one cases (85%) were immunocompetent patients. Brain MRI findings showed parenchymal involvement in 45 cases (94%), 43% with frontal lobe and 35% basal ganglia, 4% had meningeal involvement and 2% had ophthalmic involvement at diagnosis. Fifty-five percent had restricted signal on diffusion weighted imaging and contrast enhancement was found in 89%. Pyramidal syndrome was the main initial clinical manifestation (56%). There were abnormal findings in 62% of CSF samples, but in only 11.1% positive cytology results were detected. The most frequent type was diffuse large B-cell lymphoma (83%), being B-cell type the most common form between them (96%). In our series PCNSL was more frequent in immunocompetent elderly male subjects. At initial evaluation, clinical manifestations and MRI findings were variable. The initial suspicion of this entity would allow an early diagnosis, avoiding empirical treatments that may confuse or delay diagnosis.
authors.affiliation: Servicio de Neurología, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina. E-mail: lucas.alessandro.1987@gmail.com.
authors.forename: Lucas
authors.initials: L
authors.lastname: Alessandro
authors.affiliation: Servicio de Neurología, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina.
authors.forename: José M
authors.initials: JM
authors.lastname: Pastor Rueda
authors.affiliation: Servicio de Neurocirugía, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Villalonga
authors.affiliation: Servicio de Neurología, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina.
authors.forename: Verónica A
authors.initials: VA
authors.lastname: Bruno
authors.affiliation: Servicio de Neurología, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina.
authors.forename: Federico
authors.initials: F
authors.lastname: Carpani
authors.affiliation: Servicio de Medicina Interna, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina.
authors.forename: Juan B
authors.initials: JB
authors.lastname: Blaquier
authors.affiliation: Servicio de Medicina Interna, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina.
authors.forename: Sofía
authors.initials: S
authors.lastname: Tognarelli
authors.affiliation: Servicio de Neurología, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Varela
authors.affiliation: Servicio de Neuroncología, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Muggeri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016543:Central Nervous System Neoplasms / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution
keywords: HIV; central nervous system; immunocompromised patients; lymphoma