(Primary) CNS Lymphomas

What is Primary CNS Lymphoma?

Primary Central Nervous System (CNS) lymphoma is a rare type of cancer that originates in the lymphatic cells of the brain, spinal cord, or eyes. Unlike systemic lymphomas, which can spread to the CNS, primary CNS lymphoma is confined to these regions. This aggressive malignancy is classified as a non-Hodgkin lymphoma and often presents unique challenges in diagnosis and treatment.

Causes and Risk Factors

While the exact cause of primary CNS lymphoma is unclear, certain factors are associated with an increased risk:

• Immunosuppression: Conditions such as HIV/AIDS or the use of immunosuppressive drugs.

• Age: Most cases occur in individuals over the age of 60, although younger patients with compromised immune systems may also be affected.

• Genetic Mutations: Abnormal changes in specific genes involved in lymphatic cell function.

  
  

Symptoms of Primary CNS Lymphoma

The symptoms of primary CNS lymphoma vary depending on its location but may include:

• Persistent headaches

• Seizures

• Vision changes or loss

• Cognitive or behavioural changes, such as confusion or memory loss

• Weakness or numbness in the limbs

• Speech difficulties

• Unexplained nausea or vomiting

Diagnosis and Treatment Options

Diagnosis: Primary CNS lymphoma is diagnosed through a combination of advanced imaging and laboratory tests:

• MRI with contrast: Highly sensitive for detecting CNS abnormalities.

• Lumbar puncture: Analysis of cerebrospinal fluid for malignant cells or specific biomarkers.

• Biopsy: Often necessary to confirm the diagnosis and identify the specific type of lymphoma.

Treatment: Treatment for primary CNS lymphoma is complex and requires a multidisciplinary approach. Options include:

1. High-Dose Chemotherapy:

   • Methotrexate is the cornerstone drug, often given intravenously to penetrate the CNS.

   • Additional agents may be combined to enhance efficacy.

2. Radiotherapy:

   • Used for patients who cannot tolerate chemotherapy or in combination with chemotherapy for better outcomes.

   • Whole-brain radiotherapy is the most common form.

3. Targeted Therapy:

   • Emerging therapies, including monoclonal antibodies, are under investigation for improving treatment precision.

4. Stem Cell Transplantation:

   • In selected cases, high-dose chemotherapy followed by autologous stem cell transplantation may be an option.

5. Supportive Care:

   • Corticosteroids are often prescribed to reduce brain swelling and alleviate symptoms.

   • Symptom management, including anti-seizure medications, is an essential component of care.

Conclusion

Primary CNS lymphoma is a rare yet aggressive condition requiring timely diagnosis and specialised treatment. If you or a loved one experiences persistent neurological symptoms, it is crucial to seek medical attention immediately. At Singapore Brain Spine Nerves Center, our experienced team is dedicated to providing comprehensive and personalised care for patients with primary CNS lymphoma. Contact us today for expert consultation and compassionate support.