When someone develops a mass in the central nervous system, they might be experiencing symptoms of primary central nervous system lymphoma. This type of cancer has increased prevalence in the last two decades, and it accounts for about two percent to three percent of all brain tumors. In addition to the symptoms listed above, people with this type of cancer may experience seizures, double vision, difficulty swallowing, hearing loss, and facial or leg weakness.
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Patients with suspected CNS lymphoma will undergo regular appointments with a doctor or nurse. Doctors will examine the patient and ask about any symptoms they are experiencing. They may also have MRI scans performed, as the brain is a common site for lymphoma. However, the frequency of these checkups varies from patient to patient. MRI scans are usually done every three to four months in patients with lymphoma involving the brain or spinal cord. Patients who have an abnormal immune system and HIV will also undergo blood work.
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Because PCNSL is often a B-cell cancer, it may be hard to distinguish it from other forms of lymphoma. The histology of PCNSL is similar to that of non-Hodgkin's lymphomas elsewhere in the body. Staged evaluation should rule out other types of lymphomas before a diagnosis can be made. The staging process includes routine blood and urine tests, chest roentgenography, computed tomography of the abdomen, and cerebrospinal fluid cytology.
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Other symptoms of PCNSL include gait imbalance, intractable vomiting, and seizures. Although rarely associated with these symptoms, they are indicative of PCNSL. While the symptoms of PCNSL vary from patient to patient, most patients present with multiple lesions at the time of first manifestation. Some studies report incidence figures as high as 33.5%, which is more than double the normal prevalence. There are a variety of PCNSL symptoms, but some include headache, fever, fatigue, and confusion.
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Although establishing a definitive diagnosis of primary CNS lymphoma is challenging, familiarity with the symptoms can help doctors improve their suspicion. A level of suspicion is crucial for frontline physicians in emergency departments and outpatient clinics. In addition, the use of corticosteroids can decrease cerebral edema. Because steroids are lympholytic, they can decrease the yield of diagnostic procedures.
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Treatment of primary CNS lymphoma is highly effective when the tumor has not spread beyond the cerebrum, the largest part of the brain. The patient should be less than 60 years old and be able to perform daily activities, and must be free of other diseases that weaken the immune system. A patient may also undergo clinical trials if they are able to maintain sufficient levels of daily activity.
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Other symptoms of primary CNS lymphoma include seizures, increased intracranial pressure, and vitreous involvement of the eye. These symptoms may occur in a proportion of patients, with 20 percent having cancer in their eyes. In addition to floaters, patients with primary CNS lymphoma may experience incontinence, and bowel dysfunction. Some patients also experience unexplained weight loss.
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Primary CNS lymphoma symptoms may include headaches, loss of appetite, and changes in personality. Other symptoms can include vision or hearing loss, nausea, and mental alertness. Patients with primary CNS lymphoma may experience seizures, and there is a high risk of surgical complications. However, the symptoms of this disease can often be managed with other treatments such as chemotherapy or radiotherapy.
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While there is no specific staging system for CNS lymphoma, doctors will consider a number of factors when determining the best treatment for a patient. For example, the cancer's location may not have spread to the brain if the lymphoma began in another area of the body. Nonetheless, a positive response to treatment may mean a longer lifespan and improved quality of life.
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Symptoms of primary CNS lymphoma may vary based on location, but include the following: immunosuppressed patients and the elderly are considered at higher risk. People with HIV/AIDS and individuals undergoing organ transplants are also at high risk. It's important to know what to expect from primary CNS lymphoma symptoms, so you can find the right treatment for you.
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When determining the appropriate treatment, the clinician should assess the patient's overall health and the extent of any symptoms. Primary CNS lymphoma is rare, and occurs most commonly in the elderly and immunocompromised populations. Most patients with this type of cancer will show a regressed disease, although approximately 50 percent of these patients will have a relapse within two years. However, patients who have completed their treatment have a survival rate of 44 months.
