Lymphoma (Primary Central Nervous System)

Lymphoma is a disease in which malignant (cancer) cells form in the lymph system. The lymph system is part of the immune system and is made up of the lymph, lymph vessels, lymph nodes, spleen, thymus, tonsils, and bone marrow. Lymphocytes (carried in the lymph) travel in and out of the central nervous system (CNS). It is thought that some of these lymphocytes become malignant and cause lymphoma to form in the CNS. Primary CNS lymphoma can start in the brain, spinal cord, or meninges (the layers that form the outer covering of the brain). Because the eye is so close to the brain, primary CNS lymphoma can also start in the eye (called ocular lymphoma).

When primary CNS lymphoma continues to grow, it usually does not spread beyond the central nervous system or the eye. The process used to find out if cancer has spread is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. For primary CNS lymphoma, a CT scan is done of the chest, abdomen, and pelvis (the part of the body between the hips).

  • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.

  • Slit-lamp eye exam: An exam that uses a special microscope with a bright, narrow slit of light to check the outside and inside of the eye.

  • Vitrectomy: Surgery to remove some or all of the vitreous humor (the gel-like fluid inside the eyeball). The fluid is removed through tiny incisions and then viewed under a microscope by a pathologist to check for cancer cells.
There is no staging system for primary central nervous system lymphoma.

 

 

Treatment of Lymphoma:

 

Treatment of primary central nervous system (CNS) lymphoma in patients who do not have AIDS may include the following:

  • Chemotherapy.
  • Chemotherapy followed by radiation therapy.
  • Whole brain radiation therapy.
  • A clinical trial of high-dose chemotherapy with stem cell transplant.
  • Steroid therapy

Search for clinical trials in Georgia.

Adapted from the National Cancer Institute's PDQ Database: http://www.cancer.gov/cancertopics/pdq/treatment/primary-CNS-lymphoma/Patient/page2. (Accessed July 2016)