Importance of complete staging in non-Hodgkin's lymphoma presenting as a cerebral mass lesion

A. J M Ferreri, Michele Reni, Maria C. Zoldan, Maria R. Terreni, Eugenio Villa

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND. The high incidence of local failure and the lack of evidence of systemic dissemination of primary central nervous system lymphoma (PCNSL) has led some authors to conclude that complete staging with extensive tests is not necessary in patients with a lymphomatous cerebral mass who present with a focal neural syndrome. Moreover, De Angelis emphasizes that there is no report in the literature of systemic lymphoma presenting as a cerebral mass lesion, whereas others conclude that an extensive systemic evaluation is unnecessary or that the staging should be limited to physical examination, routine blood studies, and a chest radiography. METHODS. In 16 PCNSL, patients observed between 1982 and 1992, we found two patients showing systemic involvement of lymphoma after staging workup with chest X-ray, total body computerized tomography (CT) scan, cerebrospinal fluid cytology examination, and bone marrow biopsy. In one patient, a CT abdominal scan showed retroperitoneal and pelvic lymphonodal involvement, whereas in the second patient, bone marrow biopsy was positive. These systemic onsets were found no later than 2 months after the diagnosis of central nervous system involvement, which is sufficient time to conclude that these locations were present at the diagnosis of the cerebral mass. RESULTS. In the present study, complete staging demonstrated widespread dissemination (lymph node or bone marrow) in two patients with initial neurologic symptoms and a cerebral mass lesion. CONCLUSIONS. In our experience, complete staging allowed detection of systemic lymphoma in two patients initially considered to have PCNSL.

Original languageEnglish
Pages (from-to)827-833
Number of pages7
JournalCancer
Volume77
Issue number5
DOIs
Publication statusPublished - Mar 1 1996

Keywords

  • brain neoplasm
  • extranodal lymphomas
  • non-Hodgkin's lymphoma
  • primary central nervous system lymphoma
  • staging

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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