Turkish Neurosurgery 1996 , Vol 6 , Num 3-4
ăišek BAYINDIR1, Hakan SAYRAK2, Aykut KARASU1
1Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery Neuropathology Division, Istanbul, Turkey
2SSK G÷ztepe Training Hospital, Department of Pathology, Istanbul, Turkey
Eighteen patients with primary non-Hodgkin brain lymphomas without a history of any acquired or congenital immunodeficiency syndrome or organ trasplantation were reviewed retrospectively. Cases were selected from 2633 primary intracranial malignancies encountered between the years of 1987 and 1995. Eleven were male, seven were female with a mean age of 55 years (range 40-74; male predominance 1.57:1). All patients presented with neurological symptoms without any signs of extracranial lymphomatous disease. Radiological examination revealed mostly multiple lesions often located in the deep nuclei, corpus callosum and the intraventricular region. The diagnoses were made by stereotactic biopsy (7 cases), subtotal resection (6 cases), and surgical biopsy (5 cases). Histologically the most frequent type was centroblastic malignant lymphoma (50%), 72 percent of lymphomas being high-grade. Seventeen patients were treated with radiation therapy and corticosteroids. Six patients underwent subtotal resection, five received systemic chemotherapy. Three recurrences were observed, one of which was an extracranial rnetastasis to the clavicle and distal humerus. One year survival rate was 75% (median 21.5 months). Among 11 cases diagnosed by surgical biopsy or subtotal resection, there were four cases of leptomeningeal invasion which could be detected histologically, but were not detected by radiological means. This is clear evidence that these lesions may be more widespread than found radiologically. Keywords : Brain neoplasms, clinical pathology, lymphoma
Corresponding author : ăišek Bayindir