QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Home | Help | Feedback | Subscriptions | Archive | Search | Table of Contents

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (18) Citing Articles via Google Scholar Google Scholar Articles by Phan, T. G. Articles by Kurtin, P. J. Search for Related Content PubMed PubMed Citation

Posttransplant primary CNS lymphoma

Department of Neurology (T.G.P., B.P.O.) and the Division of Hematopathology (P.J.K.), Mayo Clinic and Mayo Foundation, Rochester, MN 55905

² Address correspondence and reprint requests to Brian P. O'Neill, Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905.

Abstract

The records and neuro-imaging studies of 8 cases of post-transplant primary CNS lymphoma (PT-PCNSL) diagnosed at Mayo Clinic Rochester between 1970 and 1998 were reviewed retrospectively. All patients received organ transplantation. Patients who had hematologic transplantation were not included in the analysis. The median and mean age of the 4 men and 4 women was 45 years (range, 34 to 50 years). The median duration of symptoms before diagnosis was 36 days (range, 5 to 98 days). At diagnosis, the neurologic examination was focally abnormal in 6 of 8 patients. Compared with the initial computed tomographic study, MRI showed 25 additional brain lesions. Only 43.7% of lesions enhanced with contrast agent; of those that did, all but one were heterogeneous. Ependymal contact occurred in 5 patients. MRI lesion burden increased proportionally to the interval between scans. Diagnostic tissue was obtained by stereotactic biopsy from 6 patients and by open biopsy from 2. Hemorrhage occurred in the biopsy area in 4 patients who had stereotactic biopsy and 2 died (all had normal coagulation studies). Slides available for review (7 patients) showed that the tumors were of CD20-positive lineage and were positive for Epstein-Barr virus, using in situ hybridization. Six patients died. Median survival for the cohort was 13 weeks. PT-PCNSL has clinical and imaging features distinct from typical PCNSL. In our series, (1) PT-PCNSL presented nonspecifically and progressed rapidly, (2) stereotactic brain biopsy had significant morbidity, and (3) despite multimodal therapy, survival was poor.

This article has been cited by other articles:

				B. P. O'Neill, S. Vernino, A. Dogan, and C. Giannini EBV-associated lymphoproliferative disorder of CNS associated with the use of mycophenolate mofetil Neuro-oncol, July 1, 2007; 9(3): 364 - 369. [Abstract] [Full Text] [PDF]

				M. J. Espy, J. R. Uhl, L. M. Sloan, S. P. Buckwalter, M. F. Jones, E. A. Vetter, J. D. C. Yao, N. L. Wengenack, J. E. Rosenblatt, F. R. Cockerill III, et al. Real-Time PCR in Clinical Microbiology: Applications for Routine Laboratory Testing Clin. Microbiol. Rev., January 1, 2006; 19(1): 165 - 256. [Abstract] [Full Text] [PDF]

				N. Besenski, Z. Rumboldt, O. Emovon, J. Nicholas, S. Kini, J. Milutinovic, and M. N. Budisavljevic Brain MR Imaging Abnormalities in Kidney Transplant Recipients AJNR Am. J. Neuroradiol., October 1, 2005; 26(9): 2282 - 2289. [Abstract] [Full Text] [PDF]

				S. Vernino, D. R. Salomao, T. M. Habermann, and B. P. O'Neill Primary CNS lymphoma complicating treatment of myasthenia gravis with mycophenolate mofetil Neurology, August 23, 2005; 65(4): 639 - 641. [Abstract] [Full Text] [PDF]

				R. Lai, M. K. Rosenblum, and L. M. DeAngelis Primary CNS lymphoma: A whole-brain disease? Neurology, November 26, 2002; 59(10): 1557 - 1562. [Abstract] [Full Text] [PDF]