Abstract
We examined 26 autopsy-proven cases of intracranial malignant lymphoma (IML) in immunocompetent patients to determine the extent of neoplastic involvement of the central nervous system (CNS) and to evaluate the effects of radiation on the tumor and brain tissue. All tumors were identified as diffuse non-Hodgkin's lymphomas of B-cell origin. In six patients who had not received radiotherapy, the clinical course of the disease was short and extensive infiltration of the tumor was seen. The remaining 20 patients were treated with radiotherapy and had a longer survival time. Leptomeningeal involvement was common, but extensive subarachnoid proliferation of the tumor was seen in only two cases. The posterior, but not anterior, lobe of the pituitary was involved in 5 of 22 cases, and choroid plexus involvement was seen in 4 of 21. Direct invasion of the tumor into the spinal cord, which tended to occur in patients with posterior fossa masses, was observed in 5 of 21 cases. Following irradiation, coagulation necrosis was frequently found in the invading zone as well as in the tumor mass, and degeneration of the white matter was also seen. We suggest that IML can extensively infiltrate into the CNS, including the posterior lobe of the pituitary and spinal cord, and that radiation injury to the brain appears to occur relatively easily in this disease.
Similar content being viewed by others
References
Hochberg FH, Miller DC (1988) Primary central nervous system lymphoma. J Neurosurg 68:835–853
Jellinger KA, Paulus W (1992) Primary central nervous system lymphomas—an update. J Cancer Res Clin Oncol 119:7–27
Hayakawa T, Takakura K, Abe H, et al (1994) Primary central nervous system lymphoma in Japan—a retrospective, co-operative study by CNS-Lymphoma Study Group in Japan. J Neurooncol 19:197–215
DeAngelis LM, Yahalom J, Thaler HT, et al. (1992) Combined modality therapy for primary CNS lymphoma. J Clin Oncol 10:635–643
Houthoff HJ, Poppema S, Ebels EJ, et al. (1978) Intracranial malignant lymphomas. A morphologic and immunocytologic study of twenty cases. Acta Neuropathol 44:203–210
Taylor CR, Russell R, Lukes RJ, et al. (1978) An immunohistochemical study of immunoglobulin content of primary central nervous system lymphomas. Cancer 41:2197–2205
Kumanishi T, Washiyama K, Saito T, et al. (1986) Primary malignant lymphoma of the brain: an immunohistochemical study of eight cases using a panel of monoclonal and heterologous antibodies. Acta Neuropathol 71:190–196
Adams JH, Howatson AG (1990) Cerebral lymphomas: review of 70 cases. J Clin Pathol 43:544–547
Miller DC, Hochberg FH, Harris NL, et al. (1994) Pathology with clinical correlations of primary central nervous system non-Hodgkin's lymphoma. Cancer 74:1383–1397
Tomlinson FH, Kurtin PJ, Suman VJ, et al. (1995) Primary intracerebral malignant lymphoma: a clinicopathological study of 89 patients. J Neurosurg 82:558–566
Ebels EJ (1972) Reticulosarcomas of the brain presenting as butterfly tumours. Possible implications for treatment. Eur Neurol 8:333–338
Zimmerman HM (1975) Malignant lymphomas of the nervous system. Acta Neuropathol Suppl 6:69–74
Barnard RO, Scott T (1975) Patterns of proliferation in cerebral lymphoreticular tumours. Acta Neuropathol Suppl 6:125–130
Russell DS, Rubinstein LJ (1989) Pathology of tumours of the nervous system, 5th edn. Edward Arnold, London, pp 592–608
Aho R, Ekfors T, Haltia M, et al. (1993) Pathogenesis of primary central nervous system lymphoma: invasion of malignant lymphoid cells into and within the brain parenchyme. Acta Neuropathol 86:71–76
Burger PC, Scheithauer BW (1994) Tumors of the central nervous system. Atlas of tumor pathology. Iascicle 10, 3rd series. AFIP, Washington, DC, pp 321–331
Watanabe M, Tanaka R, Takeda N, et al. (1992) Correlation of computed tomography with the histopathology of primary malignant lymphoma of the brain. Neuroradiology 34:36–42
Onda K, Tanaka R, Takahashi H, et al. (1989) Cerebral glioblastoma with cerebrospinal fluid dissemination: a clinicopathological study of 14 cases examined by complete autopsy. Neurosurgery 25:533–540
The Non-Hodgkin's Lymphoma Pathologic Classification Project (1982) The National Cancer Institute sponsored study of classifications of non-Hodgkin's lymphomas. Summary and description of a working formulation for clinical usage. Cancer 49:2112–2139
Kleihues P, Burger PC, Scheithauer BW (1993) Histological typing of tumours of the central nervous system, 2nd edn. WHO, International histological classification of tumors. Springer-Verlag, Berlin Heidelberg New York, pp 42–45
Harris NL, Jaffe ES, Stein H, et al. (1994) A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 84:1361–1392
Sagerman RH, Cassady JR, Chang CH (1967) Radiation therapy for intracranial lymphoma. Radiology 88:552–554
Sagerman RH, Collier CH, King GA (1983) Radiation therapy of microgliomas. Radiology 149:567–570
Jellinger K, Radaskiewicz TH, Slowik F (1975) Primary malignant lymphomas of the central nervous system in man. Acta Neuropathol Suppl 6:95–102
Lampert PW, Davis RL (1964) Delayed effects of radiation on the human central nervous system. “Early” and “late” delayed reactions. Neurology 4:912–917
Sheline GE, Wara WM, Smith V (1980) Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys 6:1215–1228
Hohwieler ML, Lo TCM, Silverman ML, et al. (1986) Brain necrosis after radiotherapy for primary intracerebral tumor. Neurosurgery 18:67–74
Asai A, Matsutani M, Kohno T, et al. (1989) Subacute brain atrophy after radiation therapy for malignant brain tumor. Cancer 63:1962–1974
Selch MT, Shimizu KT, De Salles AF, et al. (1994) Primary central nervous system lymphoma. Results at the University of California at Los Angeles and review of the literature. Am J Clin Oncol 17:286–293
Bleyer WA (1981) Neurologic sequelae of methotrexate and ionizing radiation: a new classification. Cancer Treat Rep 65 (Suppl 1):89–98
Glass J, Gruber ML, Cher L, et al. (1994) Preirradiation methotrexate chemotherapy of primary central nervous system lymphoma: long-term outcome. J Neurosurg 81:188–195
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Onda, K., Wakabayashi, K., Tanaka, R. et al. Intracranial malignant lymphomas: clinicopathological study of 26 autopsy cases. Brain Tumor Pathol 16, 29–35 (1999). https://doi.org/10.1007/BF02478899
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02478899