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.
People with a weakened immune system are at high risk for primary lymphoma of the brain. Common causes of a weakened immune system include HIV/AIDS and having had an organ transplant (especially heart transplant).
Primary lymphoma of the brain may be linked to Epstein-Barr Virus (EBV), especially in people with HIV/AIDS. EBV is the virus that causes mononucleosis .
Mononucleosis
Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.
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 very rare.
Symptoms
Symptoms of primary brain lymphoma may include any of the following:
- Changes in speech or vision
-
Confusion or
hallucinations
Hallucinations
Hallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind.
- Fever
-
Headaches
or
seizures
Headaches
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...
Seizures
A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain. The term "seizure...
- Leaning to 1 side when walking
- Weakness in hands or loss of coordination
-
Numbness
to hot, cold, and pain
Numbness
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
- Personality changes
- Weight loss
Exams and Tests
The following tests may be done to help diagnose a primary lymphoma of the brain:
-
Biopsy
of the brain
Biopsy
A biopsy is the removal of a small piece of tissue for laboratory examination.
-
Head CT scan
or
MRI
Head CT scan
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
MRI
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
-
Spinal tap
(lumbar puncture)
Spinal tap
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
Treatment
Primary lymphoma of the brain is usually first treated with corticosteroids. These medicines are used to control swelling and improve symptoms. The main treatment is with chemotherapy .
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Younger people may receive high-dose chemotherapy, possibly followed by an autologous stem cell transplant .
Autologous stem cell transplant
A bone marrow transplant is a procedure to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fat...
Radiation therapy of the whole brain may be done after chemotherapy.
Radiation therapy
Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells.
Boosting the immune system, such as in those with HIV, may also be tried.
You and your health care provider may need to manage other concerns during your treatment, including:
-
Having chemotherapy at home
Having chemotherapy at home
Home intravenous antibiotic therapy; Central venous catheter - home; Peripheral venous catheter - home; Port - home; PICC line - home; Infusion thera...
-
Managing your pets
during chemotherapy
Managing your pets
People with weakened immune systems may be advised to give up their pets to avoid getting diseases from the animals. People in this category include...
-
Bleeding problems
Bleeding problems
Cancer treatment - bleeding; Chemotherapy - bleeding; Radiation - bleeding; Bone marrow transplant - bleeding; Thrombocytopenia - cancer treatment...
-
Dry mouth
Dry mouth
Chemotherapy - dry mouth; Radiation therapy - dry mouth; Transplant - dry mouth; Transplantation - dry mouth
-
Eating enough calories
Eating enough calories
Getting more calories - adults; Chemotherapy - calories; Transplant - calories; Cancer treatment - calories
-
Safe eating
during cancer treatment
Safe eating
Cancer treatment - eating safely; Chemotherapy - eating safely; Immunosuppression - eating safely; Low white blood cell count - eating safely; Neutro...
Outlook (Prognosis)
Without treatment, people with primary brain lymphoma survive for less than 2 months. Those treated with chemotherapy often survive 3 to 4 years or more. This depends 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
Baehring JM, Hovhberg FH. Primary nervous system tumors in adults. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SK, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 74.
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: non-Hodgkin's lymphomas. Version 2.2016. www.nccn.org/professionals/physician_gls/pdf/nhl.pdf . Accessed March 17, 2016.
National Cancer Institute. PDQ primary CNS lymphoma treatment. Bethesda, MD: National Cancer Institute. Updated April 2, 2015. cancer.gov/cancertopics/pdq/treatment/primary-CNS-lymphoma/HealthProfessional . Accessed March 17, 2016.
Review Date: 2/12/2016
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.