#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The Impact of Corticotherapy on the Diagnostic Yield of Stereotactic Biopsy in Patients with Brain Lymphoma


Authors: J. Chrastina 1;  M. Hermanová 2;  R. Jančálek 1;  V. Feitová 3;  D. Hrabovský 1;  Z. Novák 1
Authors‘ workplace: Neurochirurgická klinika LF MU a FN U sv. Anny v Brně 1;  I. patologicko-anatomický ústav, LF MU a FN u sv. Anny v Brně 2;  Klinika zobrazovacích metod LF MU a FN u sv. Anny v Brně 3
Published in: Klin Onkol 2017; 30(6): 437-442
Category: Original Articles
doi: https://doi.org/10.14735/amko2017437

Overview

Backround:
Because of the dismal prognosis of untreated brain lymphoma early histological verification using stereobiopsy is decisive for patient with this disease. The study analysed the diagnostic yield of stereobiopsy in brain lymphoma patients with respect to prebiopsy corticosteroid administration.

Patients and Methods:
Patients with brain lymphomas were identified in a group of 162 stereotactic biopsies (108 frame-based and 54 frameless) of patients harboring suspected brain tumor. Non conclusive biopsies were reevaluated to exclude the possibility of missed lymphoma.

Results:
Total 9 patients (8.3%) and 4 patients (7.4%) had lymphomas in the frame-based and frameless stereobiopsy groups, resp. In 10 patients, corticosteroid treatment of perifocal brain oedema was conducted continually up until biopsy (including one patient with corticotherapy for pulmonary disease). Lesion regression was observed in 6 of these patients. Transient lesion remission was observed during corticotherapy in one patient with lesion recurrence after steroid discontinuation. In 2 patients, corticosteroids were not administered before biopsy. The results of stereobiopsy were inconclusive in 8 patients (4.9%). Before biopsy, the possibility of brain lymphoma was considered in 3 patients, but the final diagnoses were autoimmune vasculitis, histological changes after embolic events from the thrombosed pulmonary veins in pulmonary malformation and local inflammation.

Conclusion:
Although the extent of brain lymphoma decreased after corticosteroid administration, corticotherapy does not exclude valid diagnostic biopsy.

Key words:
brain lymphoma – stereotaxic techniques – frameless stereotaxy – stereotactic biopsy – corticosreroids

Part of the message was presented on XLI. Brno Oncological Days within the Glio Meeting and published in the form of a short abstract.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
27. 5. 2017

Accepted:
2. 7. 2017


Sources

1. van der Sanden GA, Schouten LJ, van Dick JA et al. Primary central nervous system lymphomas: incidence and survival in the Southern and Eastern Netherlands. Cancer 2002; 94 (5): 1548–1556.

2. Penn I, Porat G. Central nervous system lymphomas in organ allografts recipients. Transplantation 1995; 59 (2): 240–244.

3. Kozler P (ed). Intrakraniální nádory. 1. vyd. Praha: Galén 2007.

4. Gerstner E, Batchelor T. Primary CNS lymphoma. Expert Rev Anticancer Ther 2007; 7 (5): 689–700. doi: 10.1586/1473 7140.7.5.689.

5. Černý R, Kapla J, Machala L. Ložiskové léze CNS u pa-cientů s HIV infekcí. Cesk Slov Neurol N 2010; 73/106 (4): 374–378.

6. Cellina M, Fetoni V, Baron P et al. Unusual primary central nervous system lymphoma location involving the fourth ventricle and hypothalamus. Neuroradiol J 2015; 28 (2): 120–125. doi: 10.1177/1971400915576671.

7. Furusawa T, Okamoto K, Ito J et al. Primary central nervous system lymphoma presenting as difuse cerebral infiltration. Radiat Med 1998; 16 (2): 137–140.

8. Vokurka S, Tupý R, Boudová L et al. Klinické, histopatologické a zobrazovací charakteristiky non-hodgkinských lymfomů u pacientů s postižením mozku. Klin Onkol 2013; 26 (5): 348–353.

9. Mansour A, Qandeel M, Abdel-Razeq H et al. MR imaging features of intracranial primary CNS lymphoma in immuno competent patients. Cancer Imaging 2014; 14 (1): 22. doi: 10.1186/1470-7330-14-22.

10. Pánková J, Benešová E, Klener P et al. Primární lymfom centrální nervové soustavy. Klin Onkol 1998; 11 (4): 112–115.

11. Geppert M, Ostertag CB, Seitz G et al. Glucocorticoid therapy obscures the diagnosis of cerebral lymphoma. Acta Neuropathol 1990; 80 (6): 629–634.

12. Binnahil M, Au K, Lu JQ et al. The influence of corticosteroid on diagnostic accuracy of biopsy for primary central nervous system lymphoma. Can J Neurol Sci 2016; 43 (5): 721–725. doi: 10.1017/cjn.2016.255.

13. Choi YL, Suh YL, Kim D et al. Malignant lymphoma of the central nervous system: difficult histological diagnosis after glucocorticoid therapy prior to biopsy. Clin Neuropathol 2006; 25 (1): 29–36.

14. Dubuisson A, Kaschten B, Lénelle J et al. Primary central nervous system lymphoma report of 32 cases and review of the literature. Clin Neurol Neurosurg 2004; 107 (1): 55–63. doi: 10.1016/j.clineuro.2004.03.005.

15. Liu BL, Cheng JX, Zhang X et al. Limited role of surgery in the management of primary central nervous system lymphoma. Oncol Rep 2009; 22 (3): 439–449.

16. Sawin PD, Hitchon PW, Follet KA et al. Computer imaging – assisted stereotactic brain biopsy: a risk analysis of 225 consecutive cases. Surg Neurol 1998; 49 (6): 640–649.

17. Vaquero J, Martínez R, Rossi E et al. Primary cerebral lymphoma: the,,ghost tumor“. Case report. J Neurosurg 1984; 60 (1): 174–176. doi: 10.3171/jns.1984.60.1.0174.

18. Korner S, Raab P, Brandis A et al. Spontaneous regression of an intracerebral lymphoma (ghost tumor) in a liver-engrafted patient. Neurologist 2011; 17 (4): 218–221. doi: 10.1097/NRL.0b013e318220c666.

19. Zaki HS, Jenkinson MD, Du Plessis DG et al. Vanishing contrast enhancement in malignant glioma after corticosteroid treatment. Acta Neurochir (Wien) 2004; 146 (8): 841–845. doi: 10.1007/s00701-004-0282-8.

20. Porter AB, Giannini C, Kaufmann T et al. Primary CNS lymphoma can be histologically diagnosed after previous corticosteroid use: a pilot study to determine whether corticosteroids prezent the diagnosis of primary CNS lymphoma. Ann Neurol 2008; 63 (5): 662–667. doi: 10.1002/ana.21366.

21. Hernández Rubio L,Giner Bernabeau JC, Perez Sempere A. Primary cerebral lymphoma with spontaneous remission. Neurologia 2013; 28 (2): 123–126. doi: 10.1016/j.nrl.2011.08.002.

22. Al-Yamany M, Lozano A, Naq S et al. Spontaneous remission of primary central nervous system lymphoma: report of 3 cases and discussion of pathophysiology. J Neurooncol 1999; 42 (2): 151–159.

23. Taillibert S, Guillevin R, Menuel C et al. Brain lymphoma: usefulness of the magnetic resonance spectroscopy. J Neurooncol 2008; 86 (2): 225–229. doi: 10.1007/s11060-007-9468-2.

24. Setzer M, Herminghaus S, Marquardt G et al. Diagnostic impact of proton MRI – spectroscopy versus image guided stereotactic biopsy. Acta Neurochir (Wien) 2007; 149 (4): 379–386. doi: 10.1007/s00701-007-1126-0.

25. Aburano H, Ueda F, Yoshie Y et al. Differences between glioblastomas and primary central nervous system lymphomas in 1 H-magnetic resonance spectroscopy. Jpn J Radiol 2015; 33 (7): 392–403. doi: 10.1007/s11604-015-0430-5.

Labels
Paediatric clinical oncology Surgery Clinical oncology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#