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    Primary lymphoma of the brain

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

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

    Causes

    The cause of primary brain lymphoma is not known.

    Patients who have a weakened immune system are athigh riskof primary lymphoma of the brain. Common causes of a weakened immune system include HIVand organ transplants (especially heart transplants).

    Primary lymphoma of the brainmay belinked to Epstein-Barr Virus (EBV). This isthe 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 veryrare.

    Symptoms

    Exams and Tests

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

    • Biopsy of the brain
    • Head CT scan or MRI
    • Spinal tap (lumbar puncture)

    Treatment

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

    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 patientsmay receivehigh-dose chemotherapy, followed by an autologous stem cell transplant.

    Boosting theimmune system, such as inthose with HIV, may also be tried.

    Outlook (Prognosis)

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

    Possible 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.

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            Review Date: 2/4/2013

            Reviewed By: 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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