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Primary dural lymphomas: Clinical presentation, management, and outcome.
Karschnia, Philipp; Batchelor, Tracy T; Jordan, Justin T; Shaw, Brian; Winter, Sebastian F; Barbiero, Frank J; Kaulen, Leon D; Thon, Niklas; Tonn, Joerg-Christian; Huttner, Anita J; Fulbright, Robert K; Loeffler, Jay; Dietrich, Jorg; Baehring, Joachim M.
Afiliação
  • Karschnia P; Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
  • Batchelor TT; Department of Neurology, Yale School of Medicine, New Haven, Connecticut.
  • Jordan JT; Department of Neurosurgery, Ludwig Maximilian University, Munich, Germany.
  • Shaw B; Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
  • Winter SF; Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
  • Barbiero FJ; Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
  • Kaulen LD; Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
  • Thon N; Department of Neurology, Yale School of Medicine, New Haven, Connecticut.
  • Tonn JC; Department of Neurology, Yale School of Medicine, New Haven, Connecticut.
  • Huttner AJ; Department of Neurosurgery, Ludwig Maximilian University, Munich, Germany.
  • Fulbright RK; Department of Neurosurgery, Ludwig Maximilian University, Munich, Germany.
  • Loeffler J; Department of Pathology, Yale School of Medicine, New Haven, Connecticut.
  • Dietrich J; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.
  • Baehring JM; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Cancer ; 126(12): 2811-2820, 2020 06 15.
Article em En | MEDLINE | ID: mdl-32176324
ABSTRACT

BACKGROUND:

Clinical experience is limited for primary central nervous system (CNS) lymphoma that arises from the dura mater, which is denoted with the term primary dural lymphoma (PDL). This study was aimed at determining the relative incidence, presentation, and outcomes of PDL.

METHODS:

The institutional databases of the Divisions of Neuro-Oncology at the Massachusetts General Hospital and the Yale School of Medicine were retrospectively searched for patients with primary CNS lymphoma. Patients with pathologically confirmed dural lymphoma and no evidence of primary cerebral or systemic involvement were identified. Clinical data, diagnostic findings, treatments, and outcomes were recorded.

RESULTS:

A total of 20 patients with PDL were identified, and they represented 6.3% of the individuals with primary CNS lymphomas (20 of 316). Histopathological examination of PDL revealed the following underlying subtypes diffuse large B-cell lymphoma (10 of 20 patients), marginal zone lymphoma (6 of 20), follicular lymphoma (2 of 20), undefined B-cell non-Hodgkin lymphoma (1 of 20), and T-cell non-Hodgkin lymphoma (1 of 20). On imaging, all tumors appeared as extra-axial masses with avid contrast enhancement and mostly mimicked meningioma. The median apparent diffusion coefficient value was 667 ± 26 mm2 /s. Cerebrospinal fluid analyses and symptoms were nonspecific, and the diagnosis rested on tissue analysis. Therapeutic approaches included surgery, radiotherapy, and chemotherapy. The median overall survival was not reached after 5 years. Three patients were deceased at database closure because of tumor progression. The extent of tumor resection correlated positively with overall survival (P = .044).

CONCLUSIONS:

PDL is a rare variant of primary CNS lymphoma that can be radiographically mistaken for meningioma. The outcome is excellent with multimodality treatment, and aggressive surgery may convey a survival advantage in select cases.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias do Sistema Nervoso Central / Linfoma Tipo de estudo: Clinical_trials / Diagnostic_studies / Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias do Sistema Nervoso Central / Linfoma Tipo de estudo: Clinical_trials / Diagnostic_studies / Prognostic_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Ano de publicação: 2020 Tipo de documento: Article