Primary lymphoma of the brainBrain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; PCNSL; Lymphoma - brain
Primary lymphoma of the brain is cancer of white blood cells that starts in the brain.
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, 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 of primary brain lymphoma may include any of the following:
- Changes in speech or vision
- Confusion or hallucinations
- Headaches or seizures
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...Read Article Now Book Mark Article
- Leaning to one side when walking
- Weakness in hands or loss of coordination
- Numbness to hot, cold, and pain
- 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
- 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.Read Article Now Book Mark Article
- Spinal tap (lumbar puncture)
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.
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 uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells.
Boosting the immune system, such as in those with HIV/AIDS, may also be tried.
You and your health care provider may need to manage other concerns during your treatment, including:
- Having chemotherapy at home
- Managing your pets during chemotherapy
- Bleeding problems
- Dry mouth
- Eating enough calories
- Safe eating during cancer treatment
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 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
Baehring JM, Hochberg FH. Primary nervous system tumors in adults. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 74.
National Cancer Institute website. Primary CNS lymphoma treatment (PDQ) – health professional version. www.cancer.gov/cancertopics/pdq/treatment/primary-CNS-lymphoma/HealthProfessional. Updated January 5, 2017. Accessed March 22, 2018.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): central nervous system cancers. Version 1.2017. www.nccn.org/professionals/physician_gls/pdf/cns.pdf. Updated August 18, 2017. Accessed March 22, 2018.
Review Date: 1/19/2018
Reviewed By: Richard LoCicero, MD, private practice specializing in hematology and medical oncology, Longstreet Cancer Center, Gainesville, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.