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Primary lymphoma of the brain

Primary lymphoma of the brain is cancer of white blood cells that starts in the brain.

Alternative Names

Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain

Causes, incidence, and risk factors

The cause of primary brain lymphoma is not known.

Patients who have a weakened immune system are at high risk of primary lymphoma of the brain. Common causes of a weakened immune system include HIV  and organ transplants (especially heart transplants).

Primary lymphoma of the brain may be linked to Epstein-Barr Virus (EBV). This is the virus that causes mononucleosis , especially in people with HIV infection.

Primary brain lymphoma is more common in people ages 45 to 70. The rate of primary brain lymphoma is rising. But this cancer is still very rare.

Symptoms

  • Changes in speech
  • Changes in vision
  • Confusion
  • Fever
  • Hallucinations
  • Headaches
  • Leaning to one side when walking
  • Loss of coordination
  • Numbness to hot, cold, and pain
  • Personality changes
  • Seizures
  • Weakness in hands
  • Weight loss

Signs and tests

The following tests may be done to help diagnose a primary lymphoma of the brain:

Treatment

Primary lymphoma of the brain is usually first treated with corticosteroids to control swelling and improve symptoms. The main treatment is with chemotherapy .

Radiation therapy of the whole brain was once the main treatment for primary lymphoma of the brain. Now it is usually  given to patients who do not respond to chemotherapy.

Younger patients may receive high-dose chemotherapy, followed by an autologous stem cell transplant .

Boosting the immune system, such as in those with HIV, may also be tried.

Expectations (prognosis)

Without treatment, patients with primary brain lymphoma survive for less than 2 months. Patients who are treated with chemotherapy often survive 3 to 4 years or more, depending on whether the tumor stays in remission. Survival may improve with autologous stem cell transplant.

Complications

Possible complications include:

  • Chemotherapy side effects, including low blood counts
  • Radiation side effects, including confusion, headaches, nervous system (neurologic) problems, and tissue death
  • Return (recurrence) of the lymphoma

References

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin’s Lymphomas. Version 1.2013. Available at http://www.nccn.org/professionals/physician_gls/pdf/nhl.pdf. Accessed 01/04/2013.

National Cancer Institute. PDQ Primary CNS Lymphoma Treatment. Bethesda, MD: National Cancer Institute. Date last modified 07/09/2012. Available at http://cancer.gov/cancertopics/pdq/treatment/primary-CNS-lymphoma/HealthProfessional. Accessed 01/04/2013.

Updated: 2/4/2013

Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang


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