Primary CNS lymphoma - Revision history

ClaireLewis at 22:42, 2 October 2019

2019-10-02T22:42:58Z

← Older revision		Revision as of 22:42, 2 October 2019
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	*Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs		*Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs
	==Clinical Features==		==Clinical Features==
	*Can present with a variety of focal or nonfocal signs and symptoms		*Can present with a variety of [[focal neuro deficits\|focal]] or nonfocal signs and symptoms
	*Confusion, lethargy, memory loss, hemiparesis, aphasia, mental status changes, seizures		*[[Confusion]], [[lethargy]], memory loss, [[weakness\|hemiparesis]], aphasia, [[AMS\|mental status changes]], [[seizures]]
	*Constitutional symptoms (systemic B symptoms)		*Constitutional symptoms (systemic B symptoms) e.g. [[fever]]

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*CT scan: well-defined focal lesion, isodense or hyperdense to the gray matter		*[[head CT\|CT]] scan: well-defined focal lesion, isodense or hyperdense to the gray matter
	*MRI ~~scan~~ (higher diagnostic yield): variable, isointense or hypointense lesions on T1-weighted images		*[[brain MRI\|MRI]] (higher diagnostic yield): variable, isointense or hypointense lesions on T1-weighted images
	**Lesions that involve the corpus callosum, periventricular, or periependymal areas are more likely to be due to a lymphoma<ref>Forsyth PA. Biology and management of AIDS-associated primary CNS lymphomas. Hematol Oncol Clin North Am. 1996;10(5):1125-34.</ref>		**Lesions that involve the corpus callosum, periventricular, or periependymal areas are more likely to be due to a lymphoma<ref>Forsyth PA. Biology and management of AIDS-associated primary CNS lymphomas. Hematol Oncol Clin North Am. 1996;10(5):1125-34.</ref>
	**Solitary lesions are often large (>4cm)<ref>Thurnher MM. CNS involvement in AIDS: spectrum of CT and MR findings. Eur Radiol. 1997;7(7):1091-7.</ref>		**Solitary lesions are often large (>4cm)<ref>Thurnher MM. CNS involvement in AIDS: spectrum of CT and MR findings. Eur Radiol. 1997;7(7):1091-7.</ref>

Mholtz: Text replacement - "* " to "*"

2017-07-10T04:11:13Z

Text replacement - "* " to "*"

← Older revision		Revision as of 04:11, 10 July 2017
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	*[[AIDS]]-defining malignancy that is strongly related to [[Epstein-Barr virus]] (EBV) infection		*[[AIDS]]-defining malignancy that is strongly related to [[Epstein-Barr virus]] (EBV) infection
	*Occurs with profound immunosuppression (CD4 counts <50cells/uL)		*Occurs with profound immunosuppression (CD4 counts <50cells/uL)
	* Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs		*Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs
	==Clinical Features==		==Clinical Features==
	*Can present with a variety of focal or nonfocal signs and symptoms		*Can present with a variety of focal or nonfocal signs and symptoms

ClaireLewis at 16:28, 17 May 2017

2017-05-17T16:28:41Z

← Older revision		Revision as of 16:28, 17 May 2017
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	==Background==		==Background==
	*AIDS defining malignancy that is strongly related to [[Epstein-Barr virus]] (EBV) infection		*[[AIDS]]-defining malignancy that is strongly related to [[Epstein-Barr virus]] (EBV) infection
	*Occurs with profound immunosuppression (CD4 counts <50cells/uL)		*Occurs with profound immunosuppression (CD4 counts <50cells/uL)
	* Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs		* Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs
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	**Lesions that involve the corpus callosum, periventricular, or periependymal areas are more likely to be due to a lymphoma<ref>Forsyth PA. Biology and management of AIDS-associated primary CNS lymphomas. Hematol Oncol Clin North Am. 1996;10(5):1125-34.</ref>		**Lesions that involve the corpus callosum, periventricular, or periependymal areas are more likely to be due to a lymphoma<ref>Forsyth PA. Biology and management of AIDS-associated primary CNS lymphomas. Hematol Oncol Clin North Am. 1996;10(5):1125-34.</ref>
	**Solitary lesions are often large (>4cm)<ref>Thurnher MM. CNS involvement in AIDS: spectrum of CT and MR findings. Eur Radiol. 1997;7(7):1091-7.</ref>		**Solitary lesions are often large (>4cm)<ref>Thurnher MM. CNS involvement in AIDS: spectrum of CT and MR findings. Eur Radiol. 1997;7(7):1091-7.</ref>
	*Lumbar puncture:		*[[Lumbar puncture]]:
	**CSF cytology		**CSF cytology
	**CSF EBV PCR		**CSF EBV PCR
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	==Management==		==Management==
	*High-dose methotrexate therapy (3 g/m<sup>2</sup> for four to eight cycles)		*High-dose [[methotrexate]] therapy (3 g/m<sup>2</sup> for four to eight cycles)
	*Steroids		*[[Steroids]]
	*Potent antiretroviral therapy		*Potent antiretroviral therapy
	*Radiation therapy		*Radiation therapy

Rossdonaldson1: /* Differential Diagnosis */

2017-05-17T05:32:41Z

Differential Diagnosis

← Older revision		Revision as of 05:32, 17 May 2017
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[HIV ~~neurologic complications]]~~		{{HIV associated conditions}}

	==Evaluation==		==Evaluation==
	*CT scan: well-defined focal lesion, isodense or hyperdense to the gray matter		*CT scan: well-defined focal lesion, isodense or hyperdense to the gray matter

Lisayee25 at 06:35, 5 May 2017

2017-05-05T06:35:38Z

← Older revision		Revision as of 06:35, 5 May 2017
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	==See Also==		==See Also==
	[[HIV - AIDS (main)]]		*[[HIV - AIDS (main)]]
			*[[HIV neurologic complications]]

	==External Links==		==External Links==

Lisayee25 at 06:05, 5 May 2017

2017-05-05T06:05:04Z

← Older revision		Revision as of 06:05, 5 May 2017
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	==References==		==References==
	<references/>		<references/>

			[[Category:ID]]
			[[Category:Neurology]]

Lisayee25 at 05:59, 5 May 2017

2017-05-05T05:59:19Z

← Older revision		Revision as of 05:59, 5 May 2017
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	==Differential Diagnosis==		==Differential Diagnosis==
	[[HIV neurologic complications]]		*[[HIV neurologic complications]]
	==Evaluation==		==Evaluation==
	*CT scan: well-defined focal lesion, isodense or hyperdense to the gray matter		*CT scan: well-defined focal lesion, isodense or hyperdense to the gray matter

Lisayee25 at 05:57, 5 May 2017

2017-05-05T05:57:24Z

← Older revision		Revision as of 05:57, 5 May 2017
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	==Differential Diagnosis==		==Differential Diagnosis==
			[[HIV neurologic complications]]
	==Evaluation==		==Evaluation==
	*CT scan: well-defined focal lesion, isodense or hyperdense to the gray matter		*CT scan: well-defined focal lesion, isodense or hyperdense to the gray matter

Lisayee25 at 05:52, 5 May 2017

2017-05-05T05:52:09Z

← Older revision		Revision as of 05:52, 5 May 2017
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	==Background==		==Background==
	*AIDS defining malignancy that is strongly related to Epstein-Barr virus (EBV) infection		*AIDS defining malignancy that is strongly related to [[Epstein-Barr virus]] (EBV) infection
	*Occurs with profound immunosuppression (CD4 counts <50cells/uL)		*Occurs with profound immunosuppression (CD4 counts <50cells/uL)
	* Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs		* Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs
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	*CT scan: well-defined focal lesion, isodense or hyperdense to the gray matter		*CT scan: well-defined focal lesion, isodense or hyperdense to the gray matter
	*MRI scan (higher diagnostic yield): variable, isointense or hypointense lesions on T1-weighted images		*MRI scan (higher diagnostic yield): variable, isointense or hypointense lesions on T1-weighted images
	**Lesions that involve the corpus callosum, periventricular, or periependymal areas are more likely to be due to a lymphoma		**Lesions that involve the corpus callosum, periventricular, or periependymal areas are more likely to be due to a lymphoma<ref>Forsyth PA. Biology and management of AIDS-associated primary CNS lymphomas. Hematol Oncol Clin North Am. 1996;10(5):1125-34.</ref>
			**Solitary lesions are often large (>4cm)<ref>Thurnher MM. CNS involvement in AIDS: spectrum of CT and MR findings. Eur Radiol. 1997;7(7):1091-7.</ref>
	*Lumbar puncture:		*Lumbar puncture:
	**CSF cytology		**CSF cytology
	**CSF EBV PCR		**CSF EBV PCR
	**Should also obtain toxoplasma serologies, most are treated empirically for toxoplasma while serology is pending		**Should also obtain [[toxoplasma]] serologies, most are treated empirically for toxoplasma while serology is pending
	*Stereotactic brain biopsy if necessary		*Stereotactic brain biopsy if necessary

Lisayee25 at 05:41, 5 May 2017

2017-05-05T05:41:25Z

← Older revision		Revision as of 05:41, 5 May 2017
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	==Background==		==Background==
	*~~Caused by~~ Epstein-Barr virus (EBV)		*AIDS defining malignancy that is strongly related to Epstein-Barr virus (EBV) infection
	*Occurs with profound immunosuppression (CD4 counts <50cells/uL)		*Occurs with profound immunosuppression (CD4 counts <50cells/uL)
	* Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs		* Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs
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	*MRI scan (higher diagnostic yield): variable, isointense or hypointense lesions on T1-weighted images		*MRI scan (higher diagnostic yield): variable, isointense or hypointense lesions on T1-weighted images
	**Lesions that involve the corpus callosum, periventricular, or periependymal areas are more likely to be due to a lymphoma		**Lesions that involve the corpus callosum, periventricular, or periependymal areas are more likely to be due to a lymphoma
	*Lumbar puncture: CSF cytology		*Lumbar puncture:
			**CSF cytology
	**CSF EBV PCR		**CSF EBV PCR
	**Should also obtain toxoplasma serologies, most are treated empirically for toxoplasma while serology is pending		**Should also obtain toxoplasma serologies, most are treated empirically for toxoplasma while serology is pending
	*Stereotactic brain biopsy if ~~needed~~		*Stereotactic brain biopsy if necessary

	==Management==		==Management==
	*High-dose methotrexate therapy (3 g/m<sup>2</sup> for four to eight cycles)		*High-dose methotrexate therapy (3 g/m<sup>2</sup> for four to eight cycles)
			*Steroids
			*Potent antiretroviral therapy
			*Radiation therapy

	==Disposition==		==Disposition==

	==See Also==		==See Also==
			[[HIV - AIDS (main)]]

	==External Links==		==External Links==