Untitled

Abstract

Primary lymphomas of the central nervous system (PLCNS) of T-cell lineage are unusual. It has been suggested that T-cell PLCNS, compared to those of B-cell origin, present some differences in relation to age of presentation, gender, location of the tumor and survival. We describe two cases with T-cell PLCNS and review 22 parenchymatous T-cell PLCNS reported in the English literature. Age, gender and survival of the whole series of 24 T-cell PLCNS did not differ from that reported in large series of PLCNS where the great majority were of B-cell origin. In contrast, a location in the posterior fossa was found in 54% of T-cell PLCNS, whereas this location ranged from 12 go 29% in series of, mostly B-cell, PLCNS. T-cell PLCNS had a higher frequency (33%) of the histologic low grade small lymphocytic lymphoma than B-cell PLCNS (5%). Analysis of six T-cell PLCNS long-term survivors showed that half of them had low grade lymphomas. We conclude that T-cell PLCNS do not differ from those of B-cell origin in age of presentation or gender, but they have a preference to develop in the posterior fossa and a higher frequency of low grade histology which would probably explain the longer survival in some patients.

Primary brain T-cell lymphoma of the lymphoblastic type presenting as altered mental status

“…A prior case series and literature review suggested that pathology might be predictive of survival, with a higher frequency of long-term survivors having low-grade lymphocytic TPCNSL [23]. A larger, more recent retrospective study showed no difference in survival based on low-grade versus anaplastic histologic features [22].…”

Primary CNS T-cell Lymphomas

“…While several case series (referenced above) have made valuable contributions to the understanding of the clinical characteristics of PCNSTL, an extensive pathologic analysis/description is lacking. Several case reports and smaller case series have described the pathology and immunophenotype in varying detail 11-26 .…”

Primary CNS T-Cell Lymphoma: A Case Report on a Solitary Cerebellar Lesion and Review of Current Relevant Literature

“…Primary CNS T-cell lymphoma often present with signs of increased intracranial pressure or focal neurological deficit related to the site of the space occupying lesion, much the same as a B-cell lymphoma [11]. It is often proposed however, that PCNSTL differs from PCNSBL in terms of age of presentation, gender, location of the lesion and patient survival [12]. Based on the scarcity of published data it is difficult to either support or refute the aforementioned theory completely.…”

“…The male predominance appears to be a steadfast phenomenon, however not always to the extent found in the IPCG data. The male to female ratio's in the literature for PCNSTL is in the order of 1.7 -2.2:1 and for PCNSBL 1.4 -2.0:1 [6,7,[12][13][14]. There does appear to be a trend to a slightly greater male predominance in T-cell variant compared with B-cell variant, however the significance of this in light of the much greater numbers of PCNSBL compared with PCNSTL is unknown to the current authors.…”

“…A predilection for T-cell lymphoma to effect the in-fratentorial structures has been reported [12]. The rates of infratentorial involvement with PCNSTL is also said to be higher than that of PCNSBL.…”