An Update on Neurosurgical Management of Primary CNS Lymphoma in Immunocompetent Patients
Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that harbor a conspicuously longer diagnostic delay compared to other malignant brain tumors. The gold standard for diagnosis is stereotactic biopsy to acquire tissue for histopathological analysis and therefore neurosurgery plays...
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Published in | Frontiers in oncology Vol. 12; p. 884724 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Frontiers Media S.A
20.04.2022
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ISSN | 2234-943X 2234-943X |
DOI | 10.3389/fonc.2022.884724 |
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Abstract | Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that harbor a conspicuously longer diagnostic delay compared to other malignant brain tumors. The gold standard for diagnosis is stereotactic biopsy to acquire tissue for histopathological analysis and therefore neurosurgery plays a central role when reducing the diagnostic period is mandated. However, histopathological diagnosis could be complicated if the patient was preoperatively exposed to corticosteroids. Besides the histopathological result, diagnosis of a PCNSL also requires full diagnostic workup to exclude cerebral metastatic disease of a systemic lymphoma. Most reviews of PCNSL discuss recent advancements in systemic treatment options from an (neuro-)oncologic viewpoint, whereas our intention was to discuss the optimization of the diagnostic period and therefore describe current standards of imaging, summarizing the diagnostic workup, discussing the surgical workup and future diagnostic prospects as well as the influence of preoperative corticosteroid therapy to reduce the diagnostic delay of PCNSL patients. |
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AbstractList | Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that harbor a conspicuously longer diagnostic delay compared to other malignant brain tumors. The gold standard for diagnosis is stereotactic biopsy to acquire tissue for histopathological analysis and therefore neurosurgery plays a central role when reducing the diagnostic period is mandated. However, histopathological diagnosis could be complicated if the patient was preoperatively exposed to corticosteroids. Besides the histopathological result, diagnosis of a PCNSL also requires full diagnostic workup to exclude cerebral metastatic disease of a systemic lymphoma. Most reviews of PCNSL discuss recent advancements in systemic treatment options from an (neuro-)oncologic viewpoint, whereas our intention was to discuss the optimization of the diagnostic period and therefore describe current standards of imaging, summarizing the diagnostic workup, discussing the surgical workup and future diagnostic prospects as well as the influence of preoperative corticosteroid therapy to reduce the diagnostic delay of PCNSL patients. Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that harbor a conspicuously longer diagnostic delay compared to other malignant brain tumors. The gold standard for diagnosis is stereotactic biopsy to acquire tissue for histopathological analysis and therefore neurosurgery plays a central role when reducing the diagnostic period is mandated. However, histopathological diagnosis could be complicated if the patient was preoperatively exposed to corticosteroids. Besides the histopathological result, diagnosis of a PCNSL also requires full diagnostic workup to exclude cerebral metastatic disease of a systemic lymphoma. Most reviews of PCNSL discuss recent advancements in systemic treatment options from an (neuro-)oncologic viewpoint, whereas our intention was to discuss the optimization of the diagnostic period and therefore describe current standards of imaging, summarizing the diagnostic workup, discussing the surgical workup and future diagnostic prospects as well as the influence of preoperative corticosteroid therapy to reduce the diagnostic delay of PCNSL patients.Primary central nervous system lymphomas (PCNSL) are rare CNS tumors that harbor a conspicuously longer diagnostic delay compared to other malignant brain tumors. The gold standard for diagnosis is stereotactic biopsy to acquire tissue for histopathological analysis and therefore neurosurgery plays a central role when reducing the diagnostic period is mandated. However, histopathological diagnosis could be complicated if the patient was preoperatively exposed to corticosteroids. Besides the histopathological result, diagnosis of a PCNSL also requires full diagnostic workup to exclude cerebral metastatic disease of a systemic lymphoma. Most reviews of PCNSL discuss recent advancements in systemic treatment options from an (neuro-)oncologic viewpoint, whereas our intention was to discuss the optimization of the diagnostic period and therefore describe current standards of imaging, summarizing the diagnostic workup, discussing the surgical workup and future diagnostic prospects as well as the influence of preoperative corticosteroid therapy to reduce the diagnostic delay of PCNSL patients. |
Author | Marhold, Franz Popadic, Branko Freyschlag, Christian Franz Sherif, Camillo Scheichel, Florian Pinggera, Daniel |
AuthorAffiliation | 1 Karl Landsteiner University of Health Sciences , Krems , Austria 2 Department of Neurosurgery, University Hospital St. Poelten , St. Poelten , Austria 3 Department of Neurosurgery, Medical University of Innsbruck , Innsbruck , Austria |
AuthorAffiliation_xml | – name: 3 Department of Neurosurgery, Medical University of Innsbruck , Innsbruck , Austria – name: 1 Karl Landsteiner University of Health Sciences , Krems , Austria – name: 2 Department of Neurosurgery, University Hospital St. Poelten , St. Poelten , Austria |
Author_xml | – sequence: 1 givenname: Florian surname: Scheichel fullname: Scheichel, Florian – sequence: 2 givenname: Daniel surname: Pinggera fullname: Pinggera, Daniel – sequence: 3 givenname: Branko surname: Popadic fullname: Popadic, Branko – sequence: 4 givenname: Camillo surname: Sherif fullname: Sherif, Camillo – sequence: 5 givenname: Franz surname: Marhold fullname: Marhold, Franz – sequence: 6 givenname: Christian Franz surname: Freyschlag fullname: Freyschlag, Christian Franz |
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Copyright | Copyright © 2022 Scheichel, Pinggera, Popadic, Sherif, Marhold and Freyschlag. Copyright © 2022 Scheichel, Pinggera, Popadic, Sherif, Marhold and Freyschlag 2022 Scheichel, Pinggera, Popadic, Sherif, Marhold and Freyschlag |
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Keywords | diagnostic workup diagnostic delay corticosteroid therapy Primary central nervous system lymphoma (PCNSL) diagnostic yield |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 Edited by: Luca Ricciardi, Sapienza University of Rome, Italy Reviewed by: Antonella Mangraviti, Sant’Andrea Hospital, Italy; Giovanni Raffa, University of Messina, Italy This article was submitted to Neuro-Oncology and Neurosurgical Oncology, a section of the journal Frontiers in Oncology |
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Title | An Update on Neurosurgical Management of Primary CNS Lymphoma in Immunocompetent Patients |
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