medigraphic.com
Academia Mexicana de Neurología, A.C.

2011, Number 4

<< Back Next >>

Rev Mex Neuroci 2011; 12 (4)

Primary central nervous system lymphoma associated with acquired immunodeficiency syndrome: A 10-year experience in a referral hospital

Gijón-Mitre V, Reyes-Melo I, Chiquete E, Crabtree-Ramírez B, González-Duarte A, García-Ramos G

Language: Spanish
References: 82
Page: 187-194
PDF size: 262.56 Kb.


ABSTRACT

Introduction: Primary central nervous system lymphoma (PCNSL) is considered infrequent, even in cases of human immunodefficiency virus (HIV) infection. However, little is known about the frequency of this association in Mexico. Objective: To determine the prevalence and neurological manifestations of patients with PCNSL and the HIV/AIDS complex, in a 10-year period in a reference hospital of the Mexico City. Methods: In this retrospective study, clinical records of PCNSL cases in patients with HIV infection were reviewed from the clinical database of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, from January 2001 to January 2011. Results: In this 10-year period, the pravalence of PCNSL in patients with HIV infection was 0.2% (5 cases, age range: 30-39 years): 3 (60%) man and 2 (40%) women. Histopathological analysis was achieved in 3 cases (all diffuse large B-cell non-Hodgkin lymphoma); in the rest, diagnosis was based on the clinical presentation, suggestive neuroimaging and negative serology for toxoplasmosis. Main sign and symptoms were headache (100%), seizures (80%), papilledema (60%), multiple cranial neuropathies (60%) and hemiparesis (60%). During the first 6 months after diagnosis, 60% of the patients died due to disease activity. Conclusions: Diagnosis of PCNSL is challenging. The low prevalence here reported, as compared with relatively old series, could be a consequence of the use of highly active antiretroviral therapy, as it has been recognized in other parts of the world.


REFERENCES

  1. Fine HA, Mayer RJ. Primary central nervous system lymphoma. Ann Intern Med 1993; 119: 1093-104.

  2. Coté TR, Biggar RJ, Rosenberg P, Devesa SS, Percy C, Yellin FJ, Lemp G, et al. Non-Hodgkin’s lymphoma among people with AIDS: incidence, presentation and public health burden. Int J Cancer 1997; 73: 645-50.

  3. Cote TR, Manns A, Hardy CR, Yellin FJ, Hartge P. Epidemiology of brain lymphoma among people with or without acquired immune deficiency syndrome. AIDS/Cancer Study Group. J Natl Cancer Inst 1996; 88: 675-9.

  4. Kasamon YL, Ambinder RF. AIDS-related primary central nervous system lymphoma. Hematol Oncol Clin North Am 2005; 19: 665-87.

  5. Flinn IW, Ambinder RF. AIDS primary central nervous system lymphoma. Curr Opin Oncol 1996; 8: 373-6.

  6. Northfelt DW, Volberding P, Kaplan LD. Degree of immunodeficiency at diagnosis of AIDS associated non-Hodgkin’s lymphoma in San Diego. Proc Am Soc Clin Oncol 1992; 176: 855-60.

  7. Miller DC, Hochberg FH, Harris NL, Gruber ML, Louis DN, Cohen H. Pathology with clinical correlation of primary central nervous system non-Hodgkin’s lymphoma. Cancer 1994; 74: 1383-97.

  8. Bataille B, Delwail V, Menet E, Vandermarcq P, Ingrand P, Wager M, Guy G, et al. Primary intracerebral malignant lymphoma: report of 248 cases. J Neurosurg 2000; 92: 261-6.

  9. Hayabuchi N, Shibamoto Y, Onizuka Y. Primary central nervous system lymphoma in Japan: a nationwide survey. Int J Radiat Oncol Biol Phys 1999; 44: 265-72.

  10. Cingolani A, Fratino L, Scoppettuolo G, Antinori A. Changing pattern of primary cerebral lymphoma in the highly active antiretroviral therapy era. J Neurovirol 2005; 11: 38-44.

  11. Goplen AK, Dunlop O, Liestol K, Lingjaerde OC, Bruun JN, Maehlen J. The impact of primary central nervous system lymphoma in AIDS patients: a population-based autopsy study from Oslo. J Acquir Immune Defic Syndr Hum Retrovirol 1997; 14: 351-4.

  12. Masliah E, DeTeresa RM, Mallory ME, Hansen LA: Changes in pathological findings at autopsy in AIDS cases for the last 15 years. AIDS 2000; 14: 69-74.

  13. Ammassari A, Scoppettuolo G, Murri R, Pezzotti P, Cingolani A, Del Borgo C, De Luca A, et al. Changing disease patterns in focal brain lesion-causing disorders in AIDS. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 18: 365-71.

  14. Hernández-Rivera EG, Roel-Gómez X, Villasís-Keever A. Acquired inmunodeficiency syndrome-related lymphoma: 1. Evolution during the 20 years of the epidemic. 2. The experience at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán: 1986-2003. Rev Invest Clin 2004; 56: 186-92.

  15. Kadan-lottick NS, Skluzacek MC, Gurney JG. Decreasing incidence rates of primary central nervous system lymphoma. Cancer 2002; 95: 193-202.

  16. Carbone A, Gloghini A. AIDS-related lymphomas: from pathogenesis to pathology. Br J Haematol 2005; 130: 662-70.

  17. Spano JP, Costagliola D, Katlama C, Mounier N, Oksenhendler E, Khayat D. AIDS-related malignancies: state of the art and therapeutic challenges. J Clin Oncol 2008; 26: 4834-42.

  18. Olson JE, Janney CA, Rao RD, Cerhan JR, Kurtin PJ, Schiff D, Kaplan RS, et al. The continuing increase in the incidence of primary central nervous system non-Hodgkin lymphoma: a surveillance, epidemiology, and end results analysis. Cancer 2002; 95: 1504-10.

  19. Dal Maso L, Francesch S. Epidemiology of non-Hodgkin lymphomas and other haemolymphopoietic neoplasms in people with AIDS. Lancet Oncol 2003; 4: 110-19.

  20. Goedert JJ, Coté TR, Virgo P, Scoppa SM, Kingma DW, Gail MH, Jaffe ES, et al. Spectrum of AIDS-associated malignant disorders. Lancet 1998; 351: 1833-9.

  21. Franceschi S, Dal Maso L, Arniani S, Crosignani P, Vercelli M, Simonato L, Falcini F, et al. Risk of cancer other tan Kaposi’s sarcoma and non- Hodgkin’s lymphoma in persons with AIDS in Italy. Br J Cancer 1998; 78: 966-70.

  22. Grulich AE, Wan X, Law MG, et al. Risk of cancer in people with AIDS. AIDS1999; 13: 839-43.

  23. Biggar RJ, Curtis RE, Cote TR, Coates M, Kaldor JM. Risk of other cancers following Kaposi’s sarcoma: relation to acquired immunodeficiency syndrome. Am J Epidemiol 1994; 139: 362-8.

  24. Levine AM. Acquired immunodeficiency syndrome-related lymphoma. Blood 1992; 80: 8.

  25. Biggar RJ, Rabkin CS. The epidemiology of AIDS-related neoplasms. Hematol Oncol Clin North Am 1996; 10: 997-1010.

  26. Remick SC, Diamond C, Migliozzi JA, Solis O, Wagner H, Haase RF, Ruckdeschel JC. Primary central nervous lymphoma in patients with and without the acquired immune deficiency syndrome. Medicine 1990; 69: 345-60.

  27. Gill PS, Levine AM, Meyer PR, Boswell WD, Burkes RL, Parker JW, Hofman FM, et al. Primary central nervous system lymphoma in homosexual men. Clinical, immunologic, and pathologic features. Am J Med 1985; 78: 742-8.

  28. Knowles DM. Etiology and pathogenesis of AIDS-related non-Hodgkin’s lymphoma. Hematol Oncol Clin North Am 2003; 17: 785-820.

  29. Bibas M, Antinori A. EBV and HIV-Related Lymphoma. Mediterr J Hematol Infect Dis 2009; 29;1: e2009032.

  30. MacMahon EM, Glass JD, Hayward SD, Mann RB, Becker PS, Charache P, McArthur JC, et al. Epstein-Barr virus in AIDS-related primary central nervous system lymphoma. Lancet 1991; 338: 969-73.

  31. Bellan C, Lazzi S, DeFalco G, Nyongo A, Giordano A, Leoncini L. Burkitt’s lymphoma: new insights into molecular pathogenesis. J Clin Pathol 2003; 56: 188-93.

  32. Corti M, de Dios Soler M, Bare P, Villafañe MF, De Tezanos PM, Perez BR, Narbaitz M. AIDS related lymphomas: Histopathological subtypes and association with Epstein Barr virus and Human Herpes virus type- 8]. Medicina (B Aires). 2010; 70: 151-8.

  33. DeMarioMD, Liebowitz D. Lymphomas in the immunocompro-mised patient. Sem Oncol 1998; 25: 492-502.

  34. Gill PS, Levine A, Meyer RP, Boswell WD, Burkes RL, Parker JW, Hofman FM, et al. Primary central nervous system lymphoma in homosexual men. Clinical, immunologic and pathologic features. Am J Med 1985; 78: 742-8.

  35. Bataille B, Delwail V, Menet E, Vandermarcq P, Ingrand P, Wager M, Guy G, et al. Primary intracerebral malignant lymphoma: report of 248 cases. J Neurosurg 2000; 92: 261-6.

  36. Miller DC, Hochberg FH, Harris NL, Gruber ML, Louis DN, Cohen H. Pathology with clinical correlations of primary central nervous system non-Hodgkin’s lymphoma. The Massachusetts General Hospital experience 1958-1989. Cancer 1994; 15; 74: 1383-97.

  37. Küker W, Nägele T, Korfel A, Heckl S, Thiel E, Bamberg M, Weller M, et al. Primary central nervous system lymphomas (PCNSL): MRI features at presentation in 100 patients. J Neurooncol 2005; 72: 169-77.

  38. Johnson BA, Fram EK, Johnson PC, Jacobowitz R. The variable MR appearance of primary lymphoma of the central nervous system: comparison with histopathologic features. AJNR Am J Neuroradiol 1997; 18: 563-72.

  39. Zhang D, Hu LB, Henning TD, Ravarani EM, Zou LG, Feng XY, Wang WX, et al. MRI findings of primary CNS lymphoma in 26 immunocompetent patients. Korean J Radiol 2010; 11: 269-77.

  40. Thurnher MM, Rieger A, Kleibl-Popov C, Settinek U, Henk C, Haberler C, Schindler E. Primary central nervous system lymphoma in AIDS: a wider spectrum of CT and MRI findings. Neuroradiology 2001; 43: 29-35.

  41. Dina TS. Primary central nervous system lymphoma versus toxoplasmosis in AIDS. Radiology 1991; 179: 823-8.

  42. Utsuki S, Oka H, Abe K, Osawa S, Yamazaki T, Yasui Y, Fujii K. Primary central nervous system lymphoma in acquired immune deficiency syndrome mimicking toxoplasmosis. Brain Tumor Pathol 2011; 28: 83-7.

  43. Senocak E, O uz KK, Ozgen B, Kurne A, Ozkaya G, Unal S, Cila A. Imaging features of CNS involvement in AIDS. Diagn Interv Radiol 2010; 16: 193-200.

  44. Antinori A, Ammassari A, Luzzati R, Castagna A, Maserati R, Rizzardini G, Ridolfo A, et al. Role of brain biopsy in the management of focal brain lesions in HIV-infected patients. Gruppo Italiano Cooperativo AIDS & Tumori. Neurology 2000; 54: 993-7.

  45. Calli C, Kitis O, Yunten N, Yurtseven T, Islekel S, Akalin T. Pefusion and diffusion in MR imaging in enhancing malignant cerebral tumours. Eur J Radiol 2006; 58: 394-403.

  46. Hartmann M, Heilanda S, Harting I, Tronnier VM, Sommer C, Ludwig R, Sartor K. Distinguishing of primary cerebral lymphoma from high-grade glioma with perfusion-weighted magnetic resonance imaging. Neurosci Lett 2003; 338: 119-22.

  47. Tallibert S, Guillevin R, Menuel C, Sanson M, Hoang-Xuan K, Chiras J, Duffau H. Brain lymphoma: usefulness of the magnetic resonance spectroscopy. J Neurooncol 2008; 86: 224-9.

  48. Harting I, Hartmann M, Jost G, Sommer C, Ahmadi R, Heiland S, Sartor K. Differentiating primary central nervous systemlymphoma from glioma in humans using localised proton magnetic resonance spectroscopy. Neurosci Lett 2003; 342: 163-6.

  49. Haldorsen IS, Kråkenes J, Krossnes BK, Mella O, Espeland A. CT and MR imaging features of primary central nervous system lymphoma in Norway, 1989-2003. AJNR Am J Neuroradiol 2009; 30: 744-51.

  50. Tang YZ, Booth TC, Bhogal P, Malhotra A, Wilhelm T. Imaging of primary central nervous system lymphoma. Clin Radiol. 2011;66:768-77.

  51. Erdag N, Bhorade RM, Alberico R, Yousuf N, Patel MR. Primary lymphoma of the central nervous system: typical and atypical CT and MRI imaging appearances. AJR Am J Roentgenol 2001; 176: 1319-26.

  52. Jack Jr CR, O’neill BP, Banks PM, Reese DF. Central nervous system lymphoma: histologic types and CT appearance. Radiology 1988; 167: 211-5.

  53. Rosenblum ML, Levy RM, Bredesen DE, So YT, Wara W, Ziegler JL. Primary central nervous system lymphomas in patients with AIDS. Ann Neurol 1988; 23: 13-6.

  54. Kessler LS, Ruiz A, Donovan Post MJ, Ganz WI, Brandon AH, Foss JN. Thallium-201 brain SPECT of lymphoma in AIDS patients: pitfalls and technique optimization. AJNR Am J Roentgenol 1998; 19: 1105-9.

  55. Antinori A, Ammassari A, De Luca A, Cingolani A, Murri R, Scoppettuolo G, Fortini M, et al. Diagnosis of AIDS-related focal brain lesions: a decision-making analysis based on clinical and neuroradiologic characteristics combined with polymerase chain reaction assays in CSF. Neurology 1997; 48: 687-94.

  56. Antinori A, De Rossi G, Ammassari A, Cingolani A, Murri R, Di Giuda D, De Luca A, et al. Value of combined approach with thallium-201 single-photon emission computed tomography and Epstein-Barr virus DNA polymerase chain reaction in CSF for the diagnosis of AIDSrelated primary. CNS lymphoma1999; 17: 554-60.

  57. Cinque P, Vago L, Dahl H, Brytting M, Terreni MR, Fornara C, Racca S, et al. Polymerase chain reaction on cerebrospinal fluid for diagnosis of virus-associated opportunistic diseases of the central nervous system in HIV infected patients. AIDS 1996; 10: 951-8.

  58. Cingolani A, De Luca A, Larocca LM, Ammassari A, Scerrati M, Antinori A, Ortona L. Minimally invasive diagnosis of acquired immunodeficiency syndromerelated primary central nervous system lymphoma. J Natl Cancer Inst 1998; 90: 364-9.

  59. Ivers LC, Kim AY, Sax PE. Predictive value of polymerase chain reaction of cerebrospinal fluid for detection of Epstein-Barr virus to establish the diagnosis of HIV-related primary central nervous system lymphoma. Clin Infect Dis 2004; 38: 1629-32.

  60. Castagna A, Cinque P, d’Amico A, Messa C, Fazio F, Lazzarin A. Evaluation of contrast-enhancing brain lesions in AIDS patients by means of Epstein- Barr virus detection in cerebrospinal fluid and 201thallium single photon emission tomography. AIDS 1997; 11: 1522-3.

  61. Guidelines on the diagnosis and management of adult patients with primary CNS lymphoma (PCNSL) and primary intra-ocular lymphoma (PIOL). British Committee for Standards in Haematology 2007.

  62. De Angelis LM, Yahalom J, Heinemann MH, Cirrincione C, Thaler HT, Krol G. Primary CNS lymphoma: combined treatment with chemotherapy and radiotherapy. Neurology 1990; 40: 80-6.

  63. Damek D. Primary central nervous system lymphoma. Curr Treat Options Neurol 2003; 5: 213-22.

  64. Glass J, Shustik C, Hochberg FH, Cher L, Gruber ML. Therapy of primary central nervous system lymphoma with preirradiation methotrexate, cyclophosphamide, doxorubicin, vincristine and dexamethasone (MCHOD). J Neurooncol 1996; 30: 257-65.

  65. Dent S, Eapen L, Girard A, Hugenholtz H, DaSilva V, Stewart DJ. PROMACE-MOPP and intrathecal chemotherapy for CNS lymphomas. J Neurooncol 1996; 28: 25-30.

  66. Ng S, Rosenthal MA, Ashley D, Cher L. High dose methotrexate for primary CNS lymphoma in the elderly. Neuro Oncol 2000; 2: 40-4.

  67. Abrey LE, Yahalom J, DeAngelis LM. Treatment for primary CNS lymphoma: the next step. J Clin Oncol 2000; 18: 3144-50.

  68. DeMario MD, Liebowitz DN. Lymphomas in the immunocompromised patient. Semin Oncol 1998; 25: 492-502.

  69. Forsyth PA, Yahalom J, DeAngelis LM. Combined-modality therapy in the treatment of primary central nervous system lymphoma in AIDS. Neurology 1994; 44: 1473-9.

  70. O’Neill BP, O’Fallon JR, Earle JD, Colgan JP, Brown LD, Krigel RL. Primary central nervous system non-Hodgkin’s lymphoma: survival advantages with combined initial therapy? Int J Radiat Oncol Biol Phys 1995; 33: 663-73.

  71. Schultz CJ, Bovi J. Current management of primary central nervous system lymphoma. Int J Radiat Oncol Biol Phys 2010; 76: 666-78.

  72. Glass J, Gruber ML, Cher L, Hochberg FH. Preirradiation methotrexate chemotherapy of primary CNS lymphoma: Long-term outcome. J Neurosurg 1994; 81: 188-95.

  73. Ferreri AJ, Reni M, Pasini F, Calderoni A, Tirelli U, Pivnik A, Aondio GM, et al. A multicenter study of treatment of primary CNS lymphoma. Neurology 2002; 58: 1513-20.

  74. Jiménez VH, Domínguez V, Karpovitch XL. Linfoma primario del sistema nervioso central: epidemiología, biología, diagnóstico y tratamiento. Med Int Mex 2007; 23: 66-77.

  75. Thiel E, Korfel A, Martus P, Kanz L, Griesinger F, Rauch M, Röth A, et al. High-dose methotrexate with or without whole brain radiotherapy for primary CNS lymphoma (G-PCNSL-SG-1): a phase 3, randomised, noninferiority trial. Lancet Oncol 2010; 11: 1036-47.

  76. Abrey LE, Yahalom J, DeAngelis LM. Treatment for primary CNS lymphoma: the next step. J Clin Oncol 2000; 18: 3144-50.

  77. Gavrilovic IT, Hormigo A, Yahalom J, DeAngelis LM, Abrey LE. Longterm follow-up of high-dose methotrexate-based therapy with and without whole brain irradiation for newly diagnosed primary CNS lymphoma. J Clin Oncol 2006; 24: 4570-4

  78. Shah GD, Yahalom J, Correa DD, Lai RK, Raizer JJ, Schiff D, LaRocca R, et al. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol 2007; 25: 4730-5. Erratum in: J Clin Oncol 2008; 26: 340.

  79. Nasir S, DeAngelis LM. Update on the management of primary CNS lymphoma. Oncology (Williston Park). 2000; 14: 228-34.

  80. Ferreri AJ, Blay JY, Reni M, Pasini F, Spina M, Ambrosetti A, Calderoni A, Prognostic scoring system for primary CNS lymphomas: the International Extranodal Lymphoma Study Group experience. J Clin Oncol 2003; 21: 266-72.

  81. Pollack IF, Lunsford LD, Flickinger JC, Dameshek HL. Prognostic factors in the diagnosis and treatment of primary central nervous system lymphoma. Cancer. 1989; 63: 939-47.

  82. Abrey LE, Ben-Porat L, Panageas KS, Yahalom J, Berkey B, Curran W, Schultz C, et al. Primary central nervous system lymphoma: the Memorial Sloan-Kettering Cancer Center prognostic model. J Clin Oncol 2006; 24: 5711-5.




2020     |     www.medigraphic.com