Malignant lymphomas involving the central nervous system—a morphological and immunohistochemical study of 32 cases

Abstract

The morphological features of 32 cases of malignant lymphomas involving the central nervous system presenting over a 32 year period were reviewed and the lymphomas redefined using current classifications. Twenty-four cases (75%) of non-Hodgkin's lymphomas were reclassified using the Kiel classification. There were 18 low grade non-Hodgkin's lymphomas (comprising 11 lymphoplasmacytoid, five lymphocytic and two centroblastic-centrocytic) and six high grade tumours (comprising two centroblastic, two immunoblastic, one unclassifiable and one lymphoblastic lymphoma). Cytologically the great majority of non-Hodgkin's lymphomas were B-cell lymphomas. The eight cases (25%) of Hodgkin's disease were classified by the Rye subtype and consisted of three mixed cellularity, two lymphocyte depletion, two lymphocyte predominant and one nodular sclerosis. The presence of intracytoplasmic immunoglobulins as well as markers for histiocytic cells were studied by the immunoperoxidase technique using polyclonal antisera. A monoclonal staining pattern, as revealed by light chain restriction, was found in nine cases (38%) of the non-Hodgkin's lymphomas confirming their B-cell origin. With the Marshall's metalophil method and the other histiocytic markers, scattered reactive microglial cells and histiocytic reticulum cells were found throughout the tumours in most cases. No histiocytic lymphomas were present in the series.

Low‐grade primary central nervous system lymphoma in immunocompetent patients

“…The data on low-grade PCNSL is limited to a few case reports (Mikol et al, 1987;King et al, 1998;Braks et al, 2000) and pathological series (Jellinger et al, 1975;Bogdahn et al, 1986;Merkel & Hansmann, 1986;Simon et al, 1987;Kanav- 1990;Bergmann et al, 1993;Ferracini et al, 1993). Braks et al (2000) reported a 42-year-old woman with a 3-year history of headaches and vertigo and a 1-year history of seizures.…”

“…Their survival ranged from 12 d to 25+ months. Low-grade PCNSL cases that were included in other pathological series (Jellinger et al, 1975;Merkel & Hansmann, 1986;Simon et al, 1987;Bergmann et al, 1993;Ferracini et al, 1993) were mostly lymphoplasmacytoid immunocytomas, and no detailed description was provided. T-cell histology has been reported in <4% of PCNSL patients from Western countries (Bataille et al, 2000) and in 8AE5% from Japan (Hayabuchi et al, 1999) where some patients are positive for the human T-lymphotropic virus type 1.…”

Extranodal lymphoplasmacytoid lymphoma: spectrum of disease

“…Brain Primary central nervous system (CNS) lymphomas account for approximately 0.3-3% of all primary brain tumors and represent the most frequent primary brain tumors in patients with acquired immune deficiency syndrome [35,36]. Central nervous system secondary involvement occurs in 5-10% of patients.…”