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1. Singh T, Satheesh CT, Lakshmaiah KC, Suresh TM, Babu GK, Lokanatha D, Jacob LA, Halkud R: Primary bone lymphoma: a report of two cases and review of the literature. J Cancer Res Ther; 2010 Jul-Sep;6(3):296-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary bone lymphoma: a report of two cases and review of the literature.
  • Primary bone lymphoma (PBL) is an uncommon tumor accounting for approximately 4-5% of extra nodal lymphoma and less than 1% of all non-Hodgkin's lymphoma.
  • Disease may be complicated at presentation by pathological fracture or spinal cord compression.
  • Diffuse large-B-cell lymphoma (DLBCL) accounts for the majority of cases of PBL.
  • Owing to its rarity, only a few retrospective studies have been published addressing the prognosis and treatment of primary bone lymphoma.
  • In this paper, we report our experience with two cases of PBL treated with chemotherapy and radiotherapy and review literature to elucidate the optimal treatment of primary bone lymphoma.
  • [MeSH-major] Bone Neoplasms / pathology. Lymphoma / pathology
  • [MeSH-minor] Adult. Female. Humans. Male. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 21119256.001).
  • [ISSN] 1998-4138
  • [Journal-full-title] Journal of cancer research and therapeutics
  • [ISO-abbreviation] J Cancer Res Ther
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] India
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2. Baehring JM, Henchcliffe C, Ledezma CJ, Fulbright R, Hochberg FH: Intravascular lymphoma: magnetic resonance imaging correlates of disease dynamics within the central nervous system. J Neurol Neurosurg Psychiatry; 2005 Apr;76(4):540-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intravascular lymphoma: magnetic resonance imaging correlates of disease dynamics within the central nervous system.
  • BACKGROUND: Intravascular lymphoma (IVL) is a rare non-Hodgkin's lymphoma with relative predilection for the central nervous system.
  • An advanced magnetic resonance imaging (MRI) protocol was performed at various time points prior to diagnosis and during treatment.
  • RESULTS: MRI revealed multiple lesions scattered throughout the cerebral hemispheres; the brainstem, cerebellum, and spinal cord were less frequently involved.
  • On initial presentation, hyperintense lesions were seen on diffusion weighted images suggestive of ischaemia in three of four patients in whom the images were obtained at that time point.
  • Diffusion weighted imaging lesions either vanished or followed the typical pattern of an ischaemic small vessel stroke with evolution of abnormal FLAIR signal followed by enhancement with gadolinium in the subacute stage and tissue loss in the chronic stage.
  • Diffusion weighted imaging and FLAIR abnormalities proved to be partially reversible, correlating with the response to chemotherapy.
  • These patterns in combination with systemic findings may facilitate early diagnosis and serve as a new tool to monitor treatment response.
  • [MeSH-major] Brain Neoplasms / pathology. Diffusion Magnetic Resonance Imaging. Lymphoma, Non-Hodgkin / pathology. Vascular Neoplasms / pathology
  • [MeSH-minor] Adult. Aged. Antigens, CD / immunology. Biopsy. Brain / pathology. Cervical Vertebrae / pathology. Cognition Disorders / diagnosis. Cognition Disorders / etiology. Diagnosis, Differential. Disease Progression. Female. Functional Laterality. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Paraparesis / diagnosis. Paraparesis / etiology. Psychotic Disorders / diagnosis. Psychotic Disorders / etiology. Retrospective Studies. Thoracic Vertebrae / pathology

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  • (PMID = 15774442.001).
  • [ISSN] 0022-3050
  • [Journal-full-title] Journal of neurology, neurosurgery, and psychiatry
  • [ISO-abbreviation] J. Neurol. Neurosurg. Psychiatry
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, CD
  • [Other-IDs] NLM/ PMC1739607
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3. Yu T, Wang ZY, Ma CC: [A case of peripheral T cell lymphomas-unspecified in vertebra canal]. Beijing Da Xue Xue Bao; 2007 Aug 18;39(4):343-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Peripheral T cell lymphomas-unspecified (PTCL-U) is an uncommon malignant tumor, accounting for 5%-7% of non-Hodgkin's lymphoma.
  • Clinical feature of a case of PTCL-U was investigated and the optimal treatment protocol was proposed.
  • Bilateral leg paralysis (Grade 0/5) with high muscle tension, overactive knee reflex, bilateral Babinski sign (+) were present.
  • Magnetic resonance imaging(MRI) showed the mass, which was around spinal cord located in T6-T8 vertebra canal, with intense enhancement after the administration of gadolinium diethylenetriamine penta-acetic acid.
  • Initial diagnosis was lymphoma, multiple systems involved.
  • The patient received chemotherapy and his muscle strength was partly recovered in 4 months.
  • Early diagnosis of peripheral T cell lymphomas-unspecified was difficult and easily misdiagnosed with poor prognosis.
  • Regular radiotherapy and chemotherapy should be considered after operation.
  • However, the value of local chemotherapy need to be further investigated.
  • [MeSH-major] Epidural Neoplasms. Lymphoma, T-Cell, Peripheral

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  • (PMID = 17657255.001).
  • [ISSN] 1671-167X
  • [Journal-full-title] Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences
  • [ISO-abbreviation] Beijing Da Xue Xue Bao
  • [Language] chi
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] China
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4. Sharfuddin AA, Fatima H, Jilani SM, Mozaffar FH, Mozaffar T: The spectrum of neurological complications in Pakistani patients with malignancies. J Pak Med Assoc; 2008 Apr;58(4):160-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Most admissions (60%) occurred within the first year of diagnosis of the malignancy.
  • Neurological problems were the second commonest cause for admission (20%) in our study group following admissions for chemotherapy/transfusions (52%).
  • The most common primary tumour was Non-Hodgkin's Lymphoma (16.3%), followed by breast (15.7%), Acute Myeloid Leukemia (AML), (12.9%) and carcinoma of unknown primary site (9%).
  • The commonest neurological diagnoses were brain metastasis (27%), followed by spinal cord compression (16.9%), intracerebral haemorrhage (11.2%) and metabolic encephalopathy (9%).
  • The most common neurological diagnosis for mortality (25.8%) was intracerebral haemorrhage (34.8%), followed by brain metastasis (26.1%).
  • CONCLUSIONS: This descriptive study on neurological complications amongst cancer patients from Pakistan, defines the various neurological symptoms and diagnoses in patients with malignant disorders, highlights the common tumour types, the associated characteristics and determinants of mortality in this Asian population.

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  • (PMID = 18655420.001).
  • [ISSN] 0030-9982
  • [Journal-full-title] JPMA. The Journal of the Pakistan Medical Association
  • [ISO-abbreviation] J Pak Med Assoc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Pakistan
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5. Pels H, Vogt I, Klockgether T, Schlegel U: Primary non-Hodgkin's lymphoma of the spinal cord. Spine (Phila Pa 1976); 2000 Sep 1;25(17):2262-4

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary non-Hodgkin's lymphoma of the spinal cord.
  • OBJECTIVE: To report a rare case of primary lymphoma of the spinal cord and to discuss therapeutic options.
  • SUMMARY OF BACKGROUND DATA: Only few cases of primary spinal cord lymphomas are reported.
  • Prognosis is often poor, and therapy is not yet established.
  • METHODS: A primary lymphoplasmacytoid lymphoma of the thoracic cord in a 75-year-old woman was treated with focal radiotherapy (30 Gy) and three cycles of chemotherapy consisting of procarbazine, lomustine, and vincristine.
  • The patient was in complete remission at last follow-up (11 months after diagnosis).
  • CONCLUSIONS: Primary spinal cord lymphomas should be considered in the differential diagnosis of spinal cord tumors, especially in older patients.
  • Combination therapy with radiotherapy and chemotherapy may be superior to radiotherapy alone in these tumors.
  • Rapid initiation of treatment is essential to achieve recovery of neurologic function.
  • [MeSH-major] Lymphoma, Non-Hodgkin / pathology. Lymphoma, Non-Hodgkin / therapy. Spinal Cord Neoplasms / pathology. Spinal Cord Neoplasms / therapy
  • [MeSH-minor] Aged. Female. Humans. Magnetic Resonance Imaging. Thoracic Vertebrae. Treatment Outcome

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  • (PMID = 10973412.001).
  • [ISSN] 0362-2436
  • [Journal-full-title] Spine
  • [ISO-abbreviation] Spine
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
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6. Petit B, Roche I, Paraf F, Jaccard A, Boncoeur MP, Moreau JJ, Bordessoule D, Labrousse F: [Epidural non-Hodgkin's lymphoma presenting as a spinal cord compression]. Ann Pathol; 2001 Apr;21(2):123-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Epidural non-Hodgkin's lymphoma presenting as a spinal cord compression].
  • [Transliterated title] Lymphomes non hodgkiniens épiduraux révélés par une compression médullaire.
  • OBJECTIVE AND METHODS: epidural localization is a rare presenting sign of non Hodgkin's lymphoma.
  • In this study, we describe the clinical, histological and immunohistochemical data in 13 cases (9 men and 4 women) of non-Hodgkin's lymphoma with epidural involvement.
  • Histology and immunohistochemistry showed all tumors to be B-cell lymphomas which were classified as: lymphocytic lymphoma (3 cases), prolymphocytic lymphoma (1 case), follicular lymphoma (2 cases), diffuse large cell lymphoma (6 cases) and AIDS associated Burkitt lymphoma (1 case).
  • Median survival following complementary therapy, radiotherapy and chemotherapy in most cases, was 20 months.
  • [MeSH-major] Epidural Neoplasms / diagnosis. Lymphoma, B-Cell / diagnosis. Spinal Cord Compression / diagnosis
  • [MeSH-minor] Adult. Aged. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Female. Humans. Immunohistochemistry. Lymphoma, Follicular / diagnosis. Lymphoma, Large B-Cell, Diffuse / diagnosis. Male. Middle Aged. Neoplasm Staging. Radiotherapy. Survival Rate

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  • (PMID = 11373581.001).
  • [ISSN] 0242-6498
  • [Journal-full-title] Annales de pathologie
  • [ISO-abbreviation] Ann Pathol
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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7. Giglio P, Gilbert MR: Neurologic complications of non-Hodgkin's lymphoma. Curr Hematol Malig Rep; 2006 Dec;1(4):214-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Neurologic complications of non-Hodgkin's lymphoma.
  • Non-Hodgkin's lymphoma can affect the central and peripheral nervous systems.
  • Involvement may include parenchymal or leptomeningeal metastasis, paraneoplastic involvement, or neurologic complications resulting from chemotherapy or radiation treatment.
  • Immunosuppression related to the disease or its treatment may result in infections involving the nervous system.
  • This review discusses direct involvement of the peripheral nervous system by lymphoma, paraneoplastic syndromes associated with non-Hodgkin's lymphoma, and nervous system infections in lymphoma patients.
  • [MeSH-major] Lymphoma, Non-Hodgkin / complications. Nervous System Diseases / etiology
  • [MeSH-minor] Guillain-Barre Syndrome / etiology. Herpes Zoster / etiology. Humans. Meninges / pathology. Muscles / pathology. Nerve Compression Syndromes / etiology. Opportunistic Infections / etiology. Pain / etiology. Paraneoplastic Syndromes, Nervous System / etiology. Peripheral Nerves / pathology. Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / etiology. Spinal Cord Compression / etiology. Spinal Nerve Roots. Subarachnoid Space / pathology

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  • (PMID = 20425316.001).
  • [ISSN] 1558-822X
  • [Journal-full-title] Current hematologic malignancy reports
  • [ISO-abbreviation] Curr Hematol Malig Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 37
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8. Chua SL, Seymour JF, Streater J, Wolf MM, Januszewicz EH, Prince HM: Intrathecal chemotherapy alone is inadequate central nervous system prophylaxis in patients with intermediate-grade non-Hodgkin's lymphoma. Leuk Lymphoma; 2002 Sep;43(9):1783-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intrathecal chemotherapy alone is inadequate central nervous system prophylaxis in patients with intermediate-grade non-Hodgkin's lymphoma.
  • Central nervous system (CNS) relapse of non-Hodgkin's lymphoma (NHL) is usually fatal despite therapy and effective prophylaxis is desirable.
  • All were free of CNS involvement at diagnosis with negative cerebrospinal fluid (CSF) cytology.
  • Anthracycline-based chemotherapy was used in all cases and included high-dose methotrexate +/- ara-C in six patients.
  • The median number of i.t. treatments was 5 (range 1-12) and comprised methotrexate +/- steroid in 15, together with ara-C in 11.
  • Six CNS-relapses were observed and involved the spinal cord or brain parenchyma in two cases each, and the leptomeninges in four patients.
  • Treatment-related variables associated with higher CNS-relapse rates (34-50%) were: delay of > or = 14 days from diagnosis to first i.t. injection, < 5 i.t. treatments, delay of i.t. prophylaxis until after attaining CR and systemic treatment lacking high-dose methotrexate +/- ara-C (each P < or = 0.17). I.t.
  • [MeSH-major] Central Nervous System Neoplasms / prevention & control. Injections, Spinal. Lymphoma, Non-Hodgkin / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Antibiotics, Antineoplastic / therapeutic use. Female. Humans. Male. Methotrexate / therapeutic use. Middle Aged. Prognosis. Risk Factors. Secondary Prevention. Time Factors. Treatment Outcome

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  • (PMID = 12685832.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; YL5FZ2Y5U1 / Methotrexate
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9. Bay A, Oner AF, Etlik O, Yilmaz C, Caksen H: Myelopathy due to intrathecal chemotherapy: report of six cases. J Pediatr Hematol Oncol; 2005 May;27(5):270-2
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  • [Title] Myelopathy due to intrathecal chemotherapy: report of six cases.
  • Intrathecal chemotherapy and systemic chemotherapy are used for both prophylaxis and treatment of central nervous system disease in hematologic malignancies.
  • However, intrathecal treatment has some adverse effects, such as arachnoiditis, progressive myelopathy, and leukoencephalopathy.
  • The authors describe six children in whom myelopathy and adhesive arachnoiditis developed after administration of intrathecal chemotherapy including methotrexate, cytosine arabinoside, and prednisolone.
  • Urinary retention and incontinence, the main presenting complaints in all patients, developed within 12 hours after intrathecal therapy and spontaneously resolved within 7 days.
  • Intrathecal chemotherapy, especially methotrexate, can cause spinal cord dysfunction in children with acute lymphoblastic leukemia and non-Hodgkin's lymphoma.
  • Arachnoiditis should be kept in mind as a causative factor in recurrent urinary tract infection in patients receiving intrathecal chemotherapy.
  • [MeSH-major] Central Nervous System Neoplasms / drug therapy. Folic Acid Antagonists / adverse effects. Injections, Spinal / adverse effects. Lymphoma, Non-Hodgkin / drug therapy. Methotrexate / adverse effects. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Spinal Cord Diseases / chemically induced

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  • [CommentIn] J Pediatr Hematol Oncol. 2005 Jul;27(7):349-50 [16012322.001]
  • (PMID = 15891563.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Folic Acid Antagonists; YL5FZ2Y5U1 / Methotrexate
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10. Wei SH, Sheen JM, Huang CB, Hsiao CC: Primary spinal epidural non-Hodgkin's lymphoma in a child. Chang Gung Med J; 2001 Dec;24(12):820-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary spinal epidural non-Hodgkin's lymphoma in a child.
  • Non-Hodgkin's lymphoma usually involves the central nervous system by metastatic disease.
  • Primary spinal epidural non-Hodgkin's lymphoma (PSENL) is a relatively rare cause of spinal cord compression.
  • The proper treatment modalities are controversial in adults with PSENL.
  • Radiotherapy is the main strategy after surgery; the role of chemotherapy is uncertain.
  • Therapeutic experience in childhood PSENL is extremely limited.
  • Small non-cleaved cell non-Hodgkin's lymphoma of the epidural space was proven after subtotal tumor removal.
  • Other investigations including computed tomography of the chest and abdomen, bone scan, gallium scan, bone marrow aspiration, and cerebrospinal fluid study were all negative for occult disease.
  • The patient received combined therapy with irradiation and chemotherapy after surgery.
  • Esophageal stricture resulting from radiotherapy developed during treatment and colon interposition was performed.
  • He has remained disease free 42 months after the diagnosis with normal functional status.
  • [MeSH-major] Epidural Neoplasms / diagnosis. Lymphoma, Non-Hodgkin / diagnosis
  • [MeSH-minor] Child. Combined Modality Therapy. Humans. Male

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  • (PMID = 11858400.001).
  • [ISSN] 2072-0939
  • [Journal-full-title] Chang Gung medical journal
  • [ISO-abbreviation] Chang Gung Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China (Republic : 1949- )
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11. Peng X, Wan Y, Chen Y, Chen L, He A, Liao W, Shen J, Fu Q, Han S, Li F, Zou X: Primary non-Hodgkin's lymphoma of the spine with neurologic compression treated by radiotherapy and chemotherapy alone or combined with surgical decompression. Oncol Rep; 2009 May;21(5):1269-75
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary non-Hodgkin's lymphoma of the spine with neurologic compression treated by radiotherapy and chemotherapy alone or combined with surgical decompression.
  • Neurologic compression is a disastrous consequence for the patients with primary non-Hodgkin's lymphoma (NHL) of the spine, and such a condition has not been carefully taken into account in the treatment guidelines.
  • The aim of this study was to compare the effect of radiotherapy and chemotherapy alone or combined with surgical decompression on primary NHL of the spine with neurologic compression.
  • The neurologic deficits in 11 patients involved soft tissue extension from the vertebral tumors and 3 had vertebral fractures with motor signs and 5 had radicular pain.
  • Five patients were treated by radiotherapy and chemotherapy alone while 8 were combined with surgical decompression.
  • Five patients were not operated on but three received emergent radiotherapy before chemotherapy, 4 of whom had complete recovery in their neurologic symptoms.
  • At average follow-up of 61.5 months (range 2-156 months), 4 patients had died after an average interval of 23.3 months from treatment (range 3-71 months).
  • The 5-year overall survival rate was 82% with 60% for the patients in the surgical group, 100% for the patients in the non-surgical group.
  • The 5-year overall survival was 100% for the 8 patients who completed CHOP chemotherapy and radiotherapy.
  • It appears that optimum treatment in these patients depends on the cause of the neurologic deficits, whereas the survival is not influenced by the surgical or non-surgical treatment.
  • The results suggest that chemotherapy and radiotherapy alone is the ideal treatment for these patients whose neurologic compression was only due to soft tissue extension.
  • The authors emphasize the importance of chemotherapy and radiotherapy followed by surgical decompression depending on individual priorities in the indications for operation on primary NHL of spine with neurologic compression.
  • [MeSH-major] Decompression, Surgical / methods. Lymphoma, Non-Hodgkin / therapy. Spinal Cord Compression / therapy. Spinal Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / therapy. Neoplasm Staging. Radiotherapy, Adjuvant. Survival Rate. Treatment Outcome. Young Adult

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  • (PMID = 19360303.001).
  • [ISSN] 1021-335X
  • [Journal-full-title] Oncology reports
  • [ISO-abbreviation] Oncol. Rep.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
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12. Rabhi M, Ennibi K, Chaari J, Toloune F: [Hodgkin's disease presenting with spinal cord compression]. Rev Neurol (Paris); 2007 Nov;163(11):1109-12
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  • [Title] [Hodgkin's disease presenting with spinal cord compression].
  • Most cases reported in the literature have described advanced-stage non-Hodgkin lymphomas.
  • We report a case of spinal cord compression revealing an isolated vertebral localization of Hodgkin lymphoma.
  • After laminectomy, histology and immunohistochemistry showed Hodgkin's disease.
  • CONCLUSION: Spinal cord compression is a rare complication of Hodgkin's disease, occurring in only 5p.cent of cases, usually in the setting of progressive, advanced disease.
  • As the initial symptom of Hodgkin's disease, it is extremely rare, with only a few cases reported in the literature.
  • Significant results may be obtained with decompressive surgery and chemotherapy when the disease is promptly diagnosed.
  • Spinal cord compression by primary Hodgkin's disease is a very infrequent situation.
  • We urge this diagnosis be considered in all patients presenting with spinal cord compression attributed to malignancy.
  • [MeSH-major] Hodgkin Disease / complications. Hodgkin Disease / diagnosis. Spinal Cord Compression / etiology
  • [MeSH-minor] Decompression, Surgical. Gadolinium. Humans. Immunohistochemistry. Magnetic Resonance Imaging. Male. Middle Aged. Paraparesis, Spastic / etiology. Paraparesis, Spastic / pathology. Spinal Cord / pathology

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  • (PMID = 18033053.001).
  • [ISSN] 0035-3787
  • [Journal-full-title] Revue neurologique
  • [ISO-abbreviation] Rev. Neurol. (Paris)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] AU0V1LM3JT / Gadolinium
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13. McDonald AC, Nicoll JA, Rampling RP: Non-Hodgkin's lymphoma presenting with spinal cord compression; a clinicopathological review of 25 cases. Eur J Cancer; 2000 Jan;36(2):207-13

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Non-Hodgkin's lymphoma presenting with spinal cord compression; a clinicopathological review of 25 cases.
  • The aim of this study was to retrospectively examine 25 patients with newly diagnosed non-Hodgkin's lymphoma (NHL) presenting with spinal cord or cauda equina compression as the first symptom that were referred to our department between 1985 and 1996.
  • At presentation 17 patients were non-ambulatory; dual sphincter impairment was found in 9 patients with a further 8 patients having bladder dysfunction only.
  • All patients had a tissue diagnosis.
  • In this latter group 4 patients were treated palliatively and the remaining 16 patients received combination chemotherapy and/or radical radiation therapy.
  • We urge this diagnosis be considered in all patients presenting with spinal cord compression attributed to malignancy.
  • [MeSH-major] Lymphoma, Non-Hodgkin / complications. Spinal Cord Compression / etiology
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Follow-Up Studies. Humans. Male. Middle Aged. Retrospective Studies. Survival Analysis. Tomography, X-Ray Computed

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  • (PMID = 10741279.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] ENGLAND
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14. Rao RD, Robins HI: Non-Hodgkin's tumor and Pancoast's syndrome. Oncol Rep; 2001 Jan-Feb;8(1):165-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Non-Hodgkin's tumor and Pancoast's syndrome.
  • Chest X-ray and MRI revealed a right apical lung tumor (presumed to be a primary lung cancer), with brachial plexus infiltration and spinal cord compression.
  • Emergent radiotherapy was initiated for spinal cord compression and a biopsy was obtained 24 h later.
  • A careful review of pathology demonstrated a non-Hodgkin's lymphoma.
  • The patient subsequently received chemotherapy, and is now in remission.
  • This case illustrates the importance of a tissue diagnosis before initiating therapy for a Pancoast's tumor.
  • [MeSH-major] Carcinoma / diagnosis. Lung Neoplasms / diagnosis. Lymphoma, Non-Hodgkin / diagnosis. Pancoast Syndrome / etiology
  • [MeSH-minor] Diagnosis, Differential. Horner Syndrome / etiology. Humans. Hypesthesia / etiology. Male. Middle Aged. Muscle Weakness / etiology. Spinal Cord Compression / etiology. Urinary Retention / etiology

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  • (PMID = 11115591.001).
  • [ISSN] 1021-335X
  • [Journal-full-title] Oncology reports
  • [ISO-abbreviation] Oncol. Rep.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] GREECE
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15. Jurczak W, Wywial A, Zaluska A, Pasowicz M, Skotnicki AB: Extranodal masses compressing spinal cord in Hodgkin's disease and follicular lymphoma. J Clin Oncol; 2004 Jul 15;22(14_suppl):6728

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extranodal masses compressing spinal cord in Hodgkin's disease and follicular lymphoma.
  • : 6728 Background: Standard staging procedures in Hodgkin's disease (HD) include full physical examination and imaging studies: usually CT scan of the chest and abdomen.
  • In case of low grade lymphomas (like follicular lymphoma - FL) in advanced clinical stage, they may be even less thorough.
  • Therefore the disease within vertebral column -best visualized by magnetic resonance studies (NMR) -may be missed at diagnosis.
  • METHODS/RESULTS: During the last 2 years 3 cases of infiltration of vertebral column (extranodal masses localized within the vertebral canal, compressing but not infiltrating the spinal cord) were diagnosed in over 100 patients treated for HD and FL at that time.
  • In all 3 cases discrete neurological symptoms secondary to spinal cord and/or nerve root compression were present, resulting in further investigations.
  • In a FL patient they were diagnosed at presentation, while in two HD cases they were found 6 and 9 months after completing the first line therapy, being the cause of early relapse (primary resistance?
  • ). They were not reported in a routine 3- monthly CT scans performed in purpose to monitor non-progressive residual masses.
  • Radiotherapy -if used in the first line therapy -seems to be a feasible and effective treatment: FL patient is in CR, since IFRT was applied after chemoimmunotherapy (6 cycles of cladribine and cyclophosphamide combined with a standard dose of Rituximab, recycled at day 21); one HD patient treated with 6 cycles of ABVD and Mantle field radiotherapy relapsed evidently below the irradiated field.
  • However both HD cases developed resistance despite second line regimens and high dose chemotherapy supported by autologous stem cell transplant.
  • CONCLUSIONS: Therefore we conclude, that HD and FL patients with any neurological signs or symptoms at diagnosis should be considered as likely candidates for NMR imagind studies.

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  • (PMID = 28014665.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Gatcombe H, Lawson J, Phuphanich S, Crocker I: Treatment related myelitis in Hodgkin's lymphoma following stem cell transplant, chemotherapy and radiation: a case report and review of the literature. J Neurooncol; 2006 Sep;79(3):293-8
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  • [Title] Treatment related myelitis in Hodgkin's lymphoma following stem cell transplant, chemotherapy and radiation: a case report and review of the literature.
  • Radiation myelitis, while rare, is one of the most devastating complications of radiation treatment.
  • We report here a case of a 25-year-old Middle Eastern man with progressive myelopathy 21 months following low dose irradiation of the cord in the context of high dose chemotherapy and stem cell rescue and a review of the literature.
  • [MeSH-major] Hodgkin Disease / therapy. Myelitis / etiology. Radiation Injuries. Radiotherapy / adverse effects. Spinal Cord / radiation effects
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Humans. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local / therapy. Stem Cell Transplantation. Tomography, X-Ray Computed

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  • (PMID = 16617406.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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17. Bekar A, Cordan T, Evrensel T, Tolunay S: A case of primary spinal intramedullary lymphoma. Surg Neurol; 2001 May;55(5):261-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A case of primary spinal intramedullary lymphoma.
  • The diagnostic work-up revealed an intramedullary mass at spinal level C2-4.
  • Histological examination identified the mass as a non-Hodgkin's diffuse B-cell lymphoma.
  • The patient was treated with corticosteroids, chemotherapy, and adjuvant radiotherapy.
  • The residual tumor tissue had completely disappeared by 6 months of follow-up; however, the patient presented with intraventricular metastasis at 11 months postsurgery.
  • [MeSH-major] Cerebral Ventricle Neoplasms / secondary. Lymphoma, B-Cell / diagnosis. Lymphoma, Non-Hodgkin / diagnosis. Spinal Cord Neoplasms / diagnosis
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Diagnosis, Differential. Humans. Laminectomy. Magnetic Resonance Imaging. Male. Paresis / etiology. Radiotherapy, Adjuvant

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  • (PMID = 11516461.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 18
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18. Herrlinger U, Weller M, Küker W: Primary CNS lymphoma in the spinal cord: clinical manifestations may precede MRI detectability. Neuroradiology; 2002 Mar;44(3):239-44
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary CNS lymphoma in the spinal cord: clinical manifestations may precede MRI detectability.
  • Eight months later, after progression to tetraparesis and demonstration of an extensive contrast-enhancing intramedullary lesion giving high signal on T2-weighted images, the diagnosis of lymphoblastic non-Hodgkin's lymphoma was made by biopsy.
  • The lesion responded for a short time to corticosteroid medication, but later rapidly extended to the epidural soft tissues, probably due to a cerebrospinal fluid fistula.
  • Despite radio-and chemotherapy, the patient survived only 7 months from histological diagnosis and 15 months from the onset of symptoms.
  • [MeSH-major] Magnetic Resonance Imaging. Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis. Spinal Cord Neoplasms / diagnosis

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  • (PMID = 11942380.001).
  • [ISSN] 0028-3940
  • [Journal-full-title] Neuroradiology
  • [ISO-abbreviation] Neuroradiology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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19. Barnard M, Perez-Ordoñez B, Rowed DW, Ang LC: Primary spinal epidural mantle cell lymphoma: case report. Neurosurgery; 2000 Nov;47(5):1239-41; discussion 1242
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  • [Title] Primary spinal epidural mantle cell lymphoma: case report.
  • OBJECTIVE AND IMPORTANCE: Mantle cell lymphoma is a distinct clinicopathological type of non-Hodgkin's lymphoma that often presents at an advanced stage, with systemic spread.
  • Spinal involvement is uncommon and generally occurs as part of advanced disease or generalized relapses.
  • Primary spinal epidural lymphoma is a rare initial manifestation of non-Hodgkin's lymphoma, and mantle cell lymphoma with initial presentation in the spinal epidural space is extremely rare, having been previously reported in only two cases.
  • Magnetic resonance imaging revealed a spinal epidural mass in the lumbosacral region.
  • INTERVENTION: The patient underwent a partial L4 and L5-S1 laminectomy, with incomplete resection of the mass for spinal decompression and tissue diagnosis.
  • Mantle cell lymphoma was diagnosed in the pathological examination.
  • CONCLUSION: After radiotherapy, the disease recurred with a soft-tissue mass in the anterior maxillary area of the face.
  • The patient underwent restaging and was treated with chemotherapy, with only a partial response.
  • Mantle cell lymphoma with primary spinal epidural presentation is rare.
  • This diagnosis can be established and other causes of spinal cord compression can be ruled out by obtaining tissue for proper histopathological examinations.
  • Because of its aggressive behavior and poor prognosis, mantle cell lymphoma should be treated using a combined-modality approach.
  • [MeSH-major] Epidural Neoplasms / diagnosis. Lymphoma, Mantle-Cell / diagnosis
  • [MeSH-minor] Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Diagnosis, Differential. Humans. Laminectomy. Lumbosacral Region. Lymphoma, Non-Hodgkin / diagnosis. Magnetic Resonance Imaging. Male

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  • (PMID = 11063119.001).
  • [ISSN] 0148-396X
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
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20. Warscotte L, Duprez T, Lonneux M, Michaux L, Renard L, Sindic CJ, Lecouvet FE: Concurrent spinal cord and vertebral bone marrow radionecrosis 8 years after therapeutic irradiation. Neuroradiology; 2002 Mar;44(3):245-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Concurrent spinal cord and vertebral bone marrow radionecrosis 8 years after therapeutic irradiation.
  • Concurrent radionecrosis within the spinal cord and the bone marrow at the same thoracic level was observed 8 years after localized therapeutic irradiation in a patient who had undergone repeated cycles of radiotherapy, glucocorticoid treatment, and chemotherapy for a non-Hodgkin's lymphoma.
  • Mechanisms combining radiotoxic potentialization by glucocorticoids/alkylating agents and delayed radiation-induced vasculitis involving the common arterial pathways to the spinal cord and to the vertebrae were speculated to have acted in a synergistic way.
  • [MeSH-major] Lymphoma, Non-Hodgkin / radiotherapy. Osteoradionecrosis / etiology. Radiation Injuries / diagnosis. Radiotherapy / adverse effects. Spinal Cord Diseases / etiology
  • [MeSH-minor] Adult. Humans. Magnetic Resonance Imaging. Male. Time Factors

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  • (PMID = 11942381.001).
  • [ISSN] 0028-3940
  • [Journal-full-title] Neuroradiology
  • [ISO-abbreviation] Neuroradiology
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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21. Pels H, Deckert-Schlüter M, Glasmacher A, Kleinschmidt R, Oehring R, Fischer HP, Bode U, Schlegel U: Primary central nervous system lymphoma: a clinicopathological study of 28 cases. Hematol Oncol; 2000 Mar;18(1):21-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary central nervous system lymphoma: a clinicopathological study of 28 cases.
  • A group of 28 consecutive patients (mean age 59 years) with primary central nervous system lymphoma (PCNSL) was treated with different regimens, including steroids only, radiotherapy (RT), chemotherapy or combinations of all.
  • Lymphoma was classified as high grade malignant B-cell non-Hodgkin's lymphoma of the diffuse large cell type in each of these cases.
  • RT alone led to tumour remission in more than 70 per cent, survival could be prolonged with additional chemotherapy.
  • Thirteen patients were treated with chemotherapy alone; nine of them received a novel combined intraventricular and systemic polychemotherapy protocol based on high dose methotrexate (MTX) and high dose cytarabine (ara-C).
  • Neurotoxicity, i.e. white matter lesions associated with severe cognitive dysfunction affected both patients surviving RT more than a year and patients treated with combination RT/chemotherapy.
  • Confluent white matter hyperintense lesions were detectable on MRI in three out of 13 patients treated with chemotherapy alone, however, cognitive dysfunction has not been detected in these patients.
  • [MeSH-major] Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / radiotherapy. Lymphoma / drug therapy. Lymphoma / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / pathology. Brain Neoplasms / therapy. Cognition Disorders / etiology. Combined Modality Therapy. Cytarabine / administration & dosage. Female. Follow-Up Studies. Humans. Injections, Intraventricular. Male. Methotrexate / administration & dosage. Middle Aged. Spinal Cord Neoplasms / pathology. Spinal Cord Neoplasms / therapy. Survival Analysis. Time Factors

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  • [Copyright] Copyright 2000 John Wiley & Sons, Ltd.
  • (PMID = 10797527.001).
  • [ISSN] 0278-0232
  • [Journal-full-title] Hematological oncology
  • [ISO-abbreviation] Hematol Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 04079A1RDZ / Cytarabine; YL5FZ2Y5U1 / Methotrexate
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22. Maximiano Alonso C, Sánchez Ruiz AC, Cantos Sánchez de Ibargüen B, Méndez García M, Ronco IS, Provencio Pulla M: Ocular relapse of primary brain lymphoma in immunocompetent patient, treated with intrathecal rituximab. Clin Transl Oncol; 2010 Oct;12(10):701-3
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  • [Title] Ocular relapse of primary brain lymphoma in immunocompetent patient, treated with intrathecal rituximab.
  • Primary brain lymphoma is a rare variant of extranodal non-Hodgkin's B-cell lymphoma.
  • In >90% of cases, this is diffuse large B-cell lymphoma with CD20 expression and is confined to the brain, meninges, spinal cord, and eyes.
  • The rate of relapse after initial therapy based on high-dose methotrexate and/or total brain irradiation is high.
  • There is no consensus for treating relapse, which ranges from retreatment with high doses of methotrexate, polychemotherapy, high doses of chemotherapy backed up by autologous stem-cell transplant to intrathecal chemotherapy, with widely differing results.
  • Given the lack of consensus and poor results, new therapy options have appeared, including immunotherapy with rituximab.
  • At a systemic level, alongside chemotherapy, its results are very modest and limited due to the low concentration it reaches in cerebrospinal fluid (CSF).
  • [MeSH-major] Antibodies, Monoclonal, Murine-Derived / administration & dosage. Antineoplastic Agents / administration & dosage. Brain Neoplasms / drug therapy. Eye Neoplasms / drug therapy. Lymphoma, Large B-Cell, Diffuse / drug therapy
  • [MeSH-minor] Humans. Injections, Spinal. Male. Middle Aged. Rituximab

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  • (PMID = 20947485.001).
  • [ISSN] 1699-3055
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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23. Stern JI, Raizer JJ: Primary central nervous system lymphoma. Expert Rev Neurother; 2005 Nov;5(6 Suppl):S63-70
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary central nervous system lymphoma.
  • Primary central nervous system lymphoma is a stage 1E non-Hodgkin's lymphoma confined to the nervous system.
  • Primary central nervous system lymphoma can affect the brain, leptomeninges, spinal cord or eyes.
  • The institution of high-dose methotrexate-based regimens and whole-brain radiation therapy has significantly increased survival, but neurotoxicity is high in patients over 60 years of age.
  • Recent investigations include the use of rituximab (immunotherapy) and stem-cell transplantation, as well as regimens without whole-brain radiation therapy in the elderly.
  • The optimal treatment regimen is yet to been determined.
  • [MeSH-major] Central Nervous System Neoplasms / pathology. Central Nervous System Neoplasms / therapy. Lymphoma / pathology. Lymphoma / therapy
  • [MeSH-minor] Diagnostic Imaging / methods. Drug Therapy / methods. Expert Testimony. Humans. Lymphoma, AIDS-Related. Prognosis. Radiotherapy / methods. Salvage Therapy / methods. Stem Cell Transplantation / methods. Steroids / therapeutic use

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  • [CommentIn] Expert Rev Neurother. 2005 Nov;5(6 Suppl):1-2 [16274264.001]
  • (PMID = 16274272.001).
  • [ISSN] 1744-8360
  • [Journal-full-title] Expert review of neurotherapeutics
  • [ISO-abbreviation] Expert Rev Neurother
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Steroids
  • [Number-of-references] 76
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24. McAllister LD: Primary central nervous system lymphoma: a review. Curr Neurol Neurosci Rep; 2002 May;2(3):210-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary central nervous system lymphoma: a review.
  • Primary central nervous system lymphoma (PCNSL) is an aggressive non-Hodgkin's lymphoma associated with a poor prognosis without treatment.
  • Tissue diagnosis is accomplished by stereotactic biopsy, CSF cytology, or vitreous aspirate.
  • Corticosteroids may obscure the results of tissue specimens and are best avoided prior to tissue diagnosis.
  • PCNSL has emerged as a treatment- sensitive tumor responsive to corticosteroids, radiotherapy, and methotrexate-based chemotherapy.
  • The most effective treatment program has not yet been identified, but it is clear that regimens containing high-dose methotrexate improve survival over radiotherapy alone.
  • Because combined chemo-radiotherapy has been associated with late neurologic toxicities, especially in patients over the age of 60 years, chemotherapy without radiotherapy is being explored further.
  • Significant progress in the treatment of PCNSL has been made in the past 10 years.
  • Further progress will depend heavily on improved understanding of lymphoma biology, and future trials need to focus on improving survival rates while avoiding late neurologic toxicity.
  • [MeSH-major] Central Nervous System Neoplasms / pathology. Central Nervous System Neoplasms / therapy. Lymphoma / pathology. Lymphoma / therapy
  • [MeSH-minor] Aged. Diagnosis, Differential. Female. HIV Infections / complications. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / physiopathology. Neoplasm Recurrence, Local / prevention & control. Neoplasm Recurrence, Local / therapy

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  • (PMID = 11936999.001).
  • [ISSN] 1528-4042
  • [Journal-full-title] Current neurology and neuroscience reports
  • [ISO-abbreviation] Curr Neurol Neurosci Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 37
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25. Charfi S, Bahri Zouari I, Khabir A, Toumi N, Gouiaa N, Daoud J, Sellami Boudawara T: [Medullary compression revealing the presence of a follicular lymphoma: a case report]. Cancer Radiother; 2006 Dec;10(8):586-9
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  • [Title] [Medullary compression revealing the presence of a follicular lymphoma: a case report].
  • Epidural localization is a rare presenting sign of non-Hodgkin's lymphoma.
  • Magnetic resonance imaging revealed a spinal epidural mass extending from D7 to D9.
  • The histopathological study revealed a follicular lymphoma.
  • The patient underwent a spinal irradiation and chemotherapy.
  • Our purpose is to describe the clinical features, the pathologic findings, the treatment and the prognosis of non-Hodgkin's lymphoma revealed by an epidural involvement.
  • [MeSH-major] Epidural Neoplasms / diagnosis. Lymphoma, Follicular / diagnosis. Spinal Cord Compression / etiology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Cyclophosphamide / therapeutic use. Epirubicin / therapeutic use. Female. Follow-Up Studies. Humans. Immunohistochemistry. Laminectomy. Magnetic Resonance Imaging. Prednisone / therapeutic use. Radiotherapy Dosage. Remission Induction. Spinal Cord / pathology. Thoracic Vertebrae. Time Factors. Treatment Outcome. Vincristine / therapeutic use

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  • (PMID = 16843028.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; 5J49Q6B70F / Vincristine; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; CEOP protocol 1
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26. Aboulafia DM, Taylor L: Vacuolar myelopathy and vacuolar cerebellar leukoencephalopathy: a late complication of AIDS after highly active antiretroviral therapy-induced immune reconstitution. AIDS Patient Care STDS; 2002 Dec;16(12):579-84
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  • [Title] Vacuolar myelopathy and vacuolar cerebellar leukoencephalopathy: a late complication of AIDS after highly active antiretroviral therapy-induced immune reconstitution.
  • Controversy exists as to whether vacuolar myelopathy (VM) responds to highly active antiretroviral therapy (HAART) in a salutary fashion similar to other primary human immunodeficiency virus (HIV)-related neurologic complications such as acquired immune deficiency syndrome (AIDS) dementia complex and progressive multifocal leukoencephalopathy.
  • Herein, we describe the case of a patient with AIDS, non-Hodgkin's lymphoma, and cytomegalovirus colitis, who began HAART and cytotoxic chemotherapy.
  • After 6 months of therapy, restaging studies showed no residual lymphoma or active opportunistic infection.
  • For 2 years he was maintained on HAART, during which time his HIV viral load remained nondetectable and his CD4+ count improved from 20 to 300 cells per microliter.
  • Shortly after developing the acute onset of cerebellar ataxia, he aspirated, developed adult respiratory distress syndrome, and died.
  • At autopsy the spinal cord demonstrated a characteristic vacuolated appearance that extended into the cerebellum.
  • [MeSH-major] Acquired Immunodeficiency Syndrome / drug therapy. Antiretroviral Therapy, Highly Active. Leukoencephalopathy, Progressive Multifocal / etiology. Muscular Atrophy, Spinal / etiology. Vacuoles / pathology


27. Iványi JL, Marton E, Plander M, Gyánó G, Czumbil L, Tóth C: [Therapeutic management of central nervous system lymphomas in a single hematological institute]. Orv Hetil; 2009 Oct 18;150(42):1937-44
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  • [Title] [Therapeutic management of central nervous system lymphomas in a single hematological institute].
  • Primary central nervous system lymphoma is defined as an extranodal lymphoma arising in the central nervous system in the absence of systemic disease.
  • Because of their rare occurrence among lymphomas, optimal treatment could hardly be established.
  • AIMS: In this retrospective survey we analyzed the result of combined treatment (systemic and intrathecal chemotherapy followed by consolidation radiotherapy) in patients with primary or relapsed central nervous system lymphomas diagnosed and treated in our hematological department between 1998-2009.
  • PATIENTS AND METHODS: During this period (mean follow-up of 13.2 months) from 427 patients with newly diagnosed non-Hodgkin's lymphomas, 22 primary central nervous system lymphoma was diagnosed (5.15%, 16 cerebral and 6 spinal cord lymphoma cases).
  • All central nervous system lymphoma specimens taken with neurosurgical resection or stereotaxic biopsies were confirmed histopathologically.
  • All cerebral lymphoma cases proved to be diffuse large B-cell of origin, while in epidural lymphomas low grade subtypes also occurred.
  • Epidural lymphomas were treated with local radiotherapy (30-40 Gy), except for patients with follicular lymphomas getting rituximab-containing polychemotherapy (R + CHOP regimen) before irradiation.
  • In cerebral lymphoma (every patients had supratentorial localization) the following combined therapy protocol was used: up to three courses of high dose methotrexate (HD MTX 3g/m 2 in a single dose for 4 hours lasting drop-infusion) were given at 4-week intervals, followed by leucovorin-rescue 24 hours after MTX infusion.
  • Intrathecal combination of methotrexate, cytosin-arabinosid and dexamethasone was given three times after HD MTX infusion.
  • In complete response after chemotherapy (evaluated by cranial MRI or CT, PET/CT), whole-brain irradiation was used in a total dose of 30 Gy.
  • RESULTS: Complete remission has been achieved in 9 patients with cerebral and in 4 patients with spinal cord lymphoma (13/22; 59.0%), however, one relapsed patient became resistant and later expired, despite salvage therapy.
  • Mean of the overall survival (OS) in cerebral lymphoma was 19.5 (3-46, median of 10) months, in epidural group 14.1 (2-76, median of 5) months, whilst mean time to progression (TTP) was 4.5 (2-6.5, median of 4 months).
  • Acute toxicity of chemotherapy was usually hematological, moreover, in 8 patients impaired renal function and sepsis developed.
  • CONCLUSION: In primary central nervous system lymphoma, basic treatment HD methotrexate together with intrathecal combination of methotrexate + cytosin-arabinosid + dexamethasone followed by whole-brain irradiation of at least 30 Gy could produce a medium response rate in our study.
  • In case of relapse or progression, other salvage regimens containing HD Ara-C alternating with HD MTX could reduce the treatment failure, as well.
  • After therapy PET/CT was negative in five patients with prolonged disease-free survival.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / radiotherapy. Cranial Irradiation. Lymphoma, Non-Hodgkin / drug therapy. Lymphoma, Non-Hodgkin / radiotherapy
  • [MeSH-minor] Adult. Aged. Antibodies, Monoclonal / administration & dosage. Antibodies, Monoclonal, Murine-Derived. Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy. Chemotherapy, Adjuvant. Cyclophosphamide / administration & dosage. Cytarabine / administration & dosage. Dexamethasone / administration & dosage. Disease Progression. Doxorubicin / administration & dosage. Drug Administration Schedule. Epidural Space. Female. Humans. Hungary / epidemiology. Male. Methotrexate / administration & dosage. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Positron-Emission Tomography. Prednisone / administration & dosage. Radiotherapy Dosage. Radiotherapy, Adjuvant. Retrospective Studies. Rituximab. Salvage Therapy / methods. Survival Analysis. Tomography, X-Ray Computed. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 19812012.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Hungary
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 04079A1RDZ / Cytarabine; 4F4X42SYQ6 / Rituximab; 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; YL5FZ2Y5U1 / Methotrexate; CHOP protocol
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28. Chamberlain MC, Tsao-Wei D, Groshen S: Neoplastic meningitis-related encephalopathy. J Neurooncol; 2005 Apr;72(2):185-9
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  • Primary tumor histology included the following: breast(10 patients); non-small cell lung cancer (8); non-Hodgkin's lymphoma (8); colorectal cancer (6); melanoma (4); small cell lung cancer (2); prostate cancer (2).
  • NM at presentation revealed: encephalopathy (20 patients); spinal cord dysfunction (18); and cranial neuropathy (15).
  • All patients received intraventricular chemotherapy and 16 patients received concurrent tumor-specific systemic chemotherapy.
  • No treatment-related deaths were observed.

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  • [Journal-full-title] Journal of neuro-oncology
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  • [Language] eng
  • [Publication-type] Clinical Trial; Controlled Clinical Trial; Journal Article
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