-transparent.png){kind=logo}
OBJECTIVE Analyze the epidemiological pattern of primary central nervous system lymphoma in AIDS patients together with the clinical expression and course under treatment. METHODS We retrospectively reviewed 20 patients with AIDS-associated primary central nervous system lymphoma hospitalized in our unit between April 1992 and July 1996. Diagnosis was considered probable when an expansive intracranial process was associated with CT-scan enhancement and antitoxoplasma therapy failure in patients with extraneurological localization. Diagnosis was considered to be certain after histological confirmation. RESULTS Most-patients were male (19/20), with a median CD4 cell count of 9/mm3 (range 0-138). Ninety percent had AIDS before diagnosis. The presenting symptoms were mental status changes (70%), neurologic deficits (55%), fever without another cause (30%), increased intracranial pressure (25%) or seizures (25%). Opportunistic diseases were usually associated (60%). CT-scan (18/20) showed spontaneous iso or hyperdense lesions, most often solitary (67%), with nodular contrast enhancement (72%). When performed (7/20), magnetic resonance imaging showed hypointense lesions on T1-weighted images with marked contrast enhancement. Diagnosis of primary central nervous system lymphoma was suspected in 19 patients because of the failure of antitoxoplasma treatment; 4 patients had stereotactic biopsy which confirmed the diagnosis. Patients were treated with either total brain radiation therapy (10%), corticosteroids (30%), or both (60%). The median survival time after onset of symptoms was better with combined therapy or radiation therapy alone than with steroids alone (6 vs. 2 months). Interestingly, most of the patients died from neurological complications of lymphoma (85%). CONCLUSIONS The frequency of lymphoma-related death is probably due to better management of opportunistic infections and the effect of antiretroviral therapy. Further studies combining antiretroviral therapy, radiation and chemotherapy in patients with good performance status should be considered to improve the poor prognosis of AIDS-associated primary central nervous system lymphoma.
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
January 2004,
Tumori,
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
June 1992,
Medicina clinica,
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
January 2022,
Journal of ophthalmology,
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
January 1989,
Journal of computer assisted tomography,
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
April 1994,
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al],
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
January 1994,
Archives d'anatomie et de cytologie pathologiques,
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
January 1989,
Journal of veterinary internal medicine,
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
January 1995,
Medical and pediatric oncology,
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
January 1995,
Annales de medecine interne,
A de La Blanchardière, and
P Lesprit, and
J M Molina, and
A M Zagdanski, and
C Hennequin, and
V Garrait, and
J M Decazes, and
J Modai
January 1989,
Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society,
