Central nervous system disorders

II./4.6.: Primary central nervous system lymphoma (PCNSL)

The prevalence of PCNSL is growing, not only due to the growing number of congenital and acquired immunodeficient patients. During the past 20-30 years the prevalence of PCNSL grew from 1 to 3-4% of all brain tumours. PCNLSs do not develop from neural tissue and they only occur in the central nervous system despite the fact that lymphoid tissue is not present in the CNS. PCNL is a lymphoma of non-Hodgkin B-cell origin in 90% of cases. The tumour occurs most frequently in the age of 59, while its peak occurrence in HIV patients is around the age of 30. Leading symptoms can include changes in personality and thinking, hemi-symptoms, aphasia, headache, and rarely epileptic seizures. In case of a typical MR scan (homogenously enhancing, periventricular, deep tissue, multifocal) a stereotactic biopsy is recommended. Steroid treatment preceding the biopsy leads to full or partial remission of the tumour in 40% of the cases.