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Primary brain lymphomas in patients with a prior or concomitant malignancy

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Abstract

The increased incidence of second malignancies among cancer survivors is well documented. Thus, differential diagnosis between metastatic spread from a prior malignancy and the occurrence of a new neoplasm should be considered. This isparticularly difficult for brain lesions due to their poor prognosis that often discourages diagnostic work-up. In some cases diagnosisof a second primary neoplasm, such as primary central nervoussystem lymphomas (PCNSL), could change the therapeutic managementand the prognosis. About 8% of PCNSL occurs as a second malignancy.Homogeneous and intense tomographic enhancement, deep location of lesions and dramatic response to corticosteroids are suggestive for PCNSL and should be carefully considered before the startof treatment for cerebral lesions. Prognosis and standard management of brain metastases and PCNSL are almost completely different. In addition, while treatment of brain metastases oftenhas a palliative purpose the goal in PCNSL treatment is the cure.Four patients with PCNSL as a second malignancy are reported and literature is reviewed. Diagnosis of PCNSL changes the strategyof treatment which could have a critical therapeutic and prognosticimpact.

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References

  1. Hawkins MM, Draper GJ, Kingston JE: Incidence of second primary tumours among childhood cancer survivors. Br J Cancer 56: 339–347, 1987

    Google Scholar 

  2. Kyle RA: Second malignancies associated with chemotherapeutic agents. Semin Oncol 9: 131–142, 1982

    Google Scholar 

  3. Kohn HI, Michael Fry RJ: Radiation carcinogenesis. N Engl J Med 310: 504–511, 1984

    Google Scholar 

  4. Kaldor JM, Day NE, Pettersson F: Leukemia following chemotherapy for ovarian cancer. N Engl J Med 322: 1–6, 1990

    Google Scholar 

  5. Valagussa P, Santoro A, Fossati-Bellani F, Banfi A, Bonadonna G: Second acute leukemia and other malignancies following treatment for Hodgkin’s disease. J Clin Oncol 4: 830–837, 1986

    Google Scholar 

  6. Van Leeuwen FE, Somers R, Taal BG: Increased risk of lung cancer, non-Hodgkin’s lymphoma and leukemia following Hodgkin’s disease. J Clin Oncol 7: 1046–1058, 1989

    Google Scholar 

  7. De Angelis L: Primary central nervous system lymphoma as a secondary malignancy. Cancer 67: 1431–1435, 1991

    Google Scholar 

  8. Giromini D, Peiffer J, Tzonos T: Occurrence of a primary Burkitt-type lymphoma of the central nervous system in an astrocytoma patient. A case report. Acta Neuropathol 54: 165–167, 1981

    Google Scholar 

  9. Jellinger J, Radaszkievic T: Involvement of the central nervous system in malignant lymphomas. Virchow’s Arch A: Pathol Anat Hist 370: 345–362, 1976

    Google Scholar 

  10. Katayama Y, Shimoyama N, Yagihashi S: Primary cerebral malignant lymphoma with macroglobulinemia and carcinoma of the colon. Acta Pathol Jpn 31: 335, 1981

    Google Scholar 

  11. Davenport RD, O’Donnell LR, Schnitzer B, McKeever PE: Non-Hodgkin’s lymphoma of the brain after Hodgkin’s disease. An immunohistochemical study. Cancer 67: 440–443, 1991

    Google Scholar 

  12. Miller DC, Knee R, Schoenfeld S, Wasserstrom W, Karp G: Non-Hodgkin’s lymphoma of the CNS after treatment of Hodgkin’s disease. Am J Clin Pathol 91: 481–485, 1989

    Google Scholar 

  13. Weissman DE, Kueck BD, Merkow AB: A case of large cell CNS lymphoma associated with a systemic small cell lymphocytic lymphoma. J Neurooncol 9: 171–175, 1990

    Google Scholar 

  14. Ashby MA, Bowen D, Bleehen NM, Barber PC, Freer CEL: Primary lymphoma of the central nervous system: Experience at Addenbrooke’s Hospital, Cambridge. Clin Radiol 39: 173–181, 1988

    Google Scholar 

  15. Dorreen MS, Ironside JW, Bradsha JD, Jakubowski J, Timperley WR, Hancock BW: Primary intracerebral lymphoma: clinicopathological analysis of 14 patients presenting over a 10-year period in Sheffield. Quarterly Journal of Medicine, New Series 67: No 253, 387–404, 1988

    Google Scholar 

  16. Michalski JM, Garcia DM, Kase E, Grisby PW, Simpson JR: Primary central nervous system lymphoma: Analysis of prognostic variables and patterns of treatment failure. Radiology 176: 855–860, 1990

    Google Scholar 

  17. Murray K, Kun L, Cox J: Primary malignant lymphoma of the central nervous system. J Neurosurg 65: 600–607, 1986

    Google Scholar 

  18. Hardwidge C, Diengdoh JV, Husband D, Nash JRG: Primary cerebral lymphoma a clinico-pathologic study. Clin Neuropathol 9: 217–223, 1990

    Google Scholar 

  19. Tomlinson FH, Kurtin PJ, Suman VJ, Scheithauer BW, O’Fallon JR, Kelly PJ, Clifford RJ jr, O’Neill BP: Primary intracerebral malignant lymphoma: a clinicopathological study of 89 patients. J Neurosurg 82: 558–566, 1995

    Google Scholar 

  20. Jack CR, Reese DF, Scheithauer BW: Radiographic findings in 32 cases of primary CNS lympoma. A J R 146: 271–276, 1986

    Google Scholar 

  21. Blay JY, Lasset C, Carrie C, Chauvin F, Coiffer B, Gisselbrecht C, Clavel M, Rebattu P, Brunat-Mentigny M, Philip T, Biron P: Multivariate analysis of prognostic factors in patients with non HIV-related primary cerebral lymphoma. A proposal for a prognostic scoring. Br J Cancer 67: 1136–1141, 1993

    Google Scholar 

  22. Glass J, Gruber ML, Cher L, Hochberg FH: Preirradiation methotrexate chemotherapy of primary central nervous system lymphoma: long-term outcome. J Neurosurg 81: 188–195, 1994

    Google Scholar 

  23. Fine HA, Mayer RJ: Primary central nervous lymphoma. Ann Intern Med 119: 1093–1104, 1993

    Google Scholar 

  24. Good AE, Russo HR, Schnitzer B: Intracranial histiocytic lymphoma with rheumatoid arthritis. J Rheumatol 5: 75–78, 1978

    Google Scholar 

  25. Lipsmeyer EA: Development of malignant cerebral lymphoma in a patient with systemic lupus erythematous treated with immunosuppression. Arthritis Rheum 15: 183–186, 1972

    Google Scholar 

  26. Frizzera G, Rosai J, Dehner LP, Spector BD, Kersey JH: Lymphoreticular disorders in primary immunodeficiencies: new findings based on an up-to-date histologic classification of 35 cases. Cancer 46: 692–699, 1980

    Google Scholar 

  27. Kyritsis AP, Yung WKA, Leeds NE, Bruner J, Gleason MJ, Levin VA: Multifocal cerebral gliomas associated with secondary malignancies. The Lancet 339: 1229–1230, 1992

    Google Scholar 

  28. Kyritsis AP, Levin VA, Yung WKA, Leeds NE: Imaging patterns of multifocal gliomas. E J Radiol 16: 163–170, 1993

    Google Scholar 

  29. DeAngelis LM: Cerebral lymphoma presenting as a nonenhancing lesion on computed tomographic/magnetic resonance scan. Ann Neurol 33: 308–311, 1993

    Google Scholar 

  30. Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, Markesbery WR, MacDonald JS, Young B: A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322: 494–500, 1990

    Google Scholar 

  31. Todd NV, McDonagh T, Miller JD: What follows diagnosis by computed tomography of solitary brain tumour? Audit of one year’s experience in southeast Scotland. The Lancet 1: 611–612, 1987

    Google Scholar 

  32. Shibamoto Y, Tsutsui K, Dodo Y, Yamabe H, Shima N, Abe M: Improved survival rate in primary intracranial lymphoma treated by high-dose radiation and systemic Vincristine–Doxorubicin–Cyclophosphamide–Prednisolone chemotherapy. Cancer 65: 1907–1912, 1990

    Google Scholar 

  33. Gabbai AA, Hochberg FH, Linggood R: High dose methotrexate therapy of primary brain lymphoma. J Neurosurg 70: 190–194, 1989

    Google Scholar 

  34. DeAngelis LM, Yahalom J, Thaler HT, Kher U: Combined modality therapy for primary CNS lymphoma. J Clin Oncol 10: 635–643, 1992

    Google Scholar 

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Authors and Affiliations

  1. Department of Radiochemotherapy, Italy

    Michele Reni, Andrés J.M. Ferreri & Eugenio Villa

  2. Department of Pathology, San Raffaele H Scientific Institute, via Olgettina 60, 20132-, Milan, Italy

    Maria C. Zoldan

Authors
  1. Michele Reni
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  2. Andrés J.M. Ferreri
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  3. Maria C. Zoldan
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  4. Eugenio Villa
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Reni, M., Ferreri, A.J., Zoldan, M.C. et al. Primary brain lymphomas in patients with a prior or concomitant malignancy. J Neurooncol 32, 135–142 (1997). https://doi.org/10.1023/A:1005781815202

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