Protean clinical and radiological manifestations in 7 cases of primary malignant lymphoma of the brain
Huang, C.C.; Chen, S.T.; Hsi, M.S.; Shih, L.Y.
Journal of the Formosan Medical Association 86(10): 1093-1101
1987
ISSN/ISBN: 0371-7682 PMID: 3437259 Document Number: 290746
Seven patients with primary malignant lymphoma of the brain were studied. The age of onset was between 20 and 30 years in 2 patients, and between 53 and 61 in the other 5. Six patients were diagnosed by examination of surgical specimens and one by autopsy. In this study, 3 cases (43%) had a single lesion and 4 cases (57%) with multiple lesions. The broad variability of clinical and radiological features often caused diagnostic difficulty in differentiating among metastasis, glioma, meningioma, abscess and multiple sclerosis. The discrepancy between marked enhancement in postcontrast computed tomography and hypovascularity in angiography was peculiar. However, a definite diagnosis depended on surgical biopsy or autopsy. Histologic studies showed diffuse histiocytic lymphoma in 5 cases, diffuse poorly-differentiated lymphocytic lymphoma in 1 case and lymphoblastic lymphoma in the remaining 1. Four patients with a complete course of radiation therapy had a median survival time of 20 months, and 3 of them are still alive at the time of this writing. The other 3 patients who received either incomplete or no radiotherapy died within 5 months. Irradiation seems to be the cornerstone of therapy. Subsequent chemotherapy was effective in a patient who had recurrence after radiotherapy.