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What is CNS Lymphoma?

Central Nervous System (CNS) lymphoma is a disease in which malignant cancer cells form in the lymph tissue of the brain and/or spinal cord. The lymphatic system is part of the immune system and is made up of the lymph, lymph vessels, lymph node, spleen, thymus, tonsils, and bone marrow. Lymphocytes carried in the lymph, travel in and out of the central nervous system.


What are the symptoms of CNS Lymphoma?

Cancer cells form in the lymphatic tissue in the brain; this is often in an area called the cerebrum. Symptoms may include:

  • An increase in pressure within the skull
  • Changes in behavior and personality 
  • Seizures
  • Changes in balance and movement
  • Numbness or weakness
  • Problems with vision

These symptoms may look like other conditions or health problems; always consult your physician for a diagnosis.


What causes CNS lymphoma?

The cause of CNS lymphoma is not usually known. Most patients who develop this type of cancer have a normal immune system, however, it may affect people whose immune system is not working properly - for example, in people with HIV or after organ transplants. 


How is CNS lymphoma diagnosed?

Your physician will review your health history and do a physical exam, checking your nervous system. This includes checking your reflexes and the power and feeling in your arms and legs. In addition, your physician will shine a light at the back of your eye to check if the optic nerve is swollen, which can be a sign of raised pressure in the brain. Your physician will also ask questions to test your reasoning and memory. Blood tests will be taken to check the number of cells in your blood and to see how well your kidneys and liver are working.

The physician may have a CT or MRI scan done in order to find out the exact position and size of the tumor, if necessary. A CT scan uses special x-ray equipment to obtain image data from different angles around the body and then uses computer processing equipment of the information to show 3-D images and cross-sectional images of the of body tissues and organs. You may be given a dye injection which allows particular areas to be seen more clearly; this may make you feel hot all over for a few minutes. If you are allergic to iodine or have asthma you could have a more serious reaction to the injection, so it's important to let your physician know before the scan. An MRI is similar to a CT scan but uses magnetism instead of x-rays to create a detailed picture of areas of your body.

A lumbar puncture is performed to see if there are any tumor cells present in the cerebrospinal fluid (CSF) . Your physician will use a local anesthetic to numb the lower part of your back; a needle is passed gently into the spine to take a small sample of CSF to check for lymphoma cells. This procedure is usually done as an outpatient procedure and only takes a few minutes.

A bone marrow sample may be performed to check if the lymphoma has started outside the brain or not. A small sample of bone marrow is taken from the back of the hip bone or breast bone and is sent to a lab to check for abnormal white blood cells. A local anesthetic injection will be given to numb the area as well as a short-acting sedative to reduce any pain or discomfort during the test. A needle is passed through the skin into the bone drawing a sample of liquid and a small care of bone marrow from inside the bone into a syringe; you may experience discomfort for a few seconds during this time.

To diagnose CNS lymphoma, a biopsy will be performed in which a small sample of tissue from the tumor will be removed. This sample will be examined under a microscope by a physician to find out what type of cells are present. 


What are the treatments for CNS lymphoma?

Treatment for CNS lymphoma will depend on your situation and general health. Treatments include:

  • Chemotherapy; this is usually the main treatment for CNS lymphoma and uses anti-cancer medications to destroy cancer cells. Your physician will discuss chemotherapy options with you.
  • Radiotherapy; this treatment uses high energy rays to destroy the cancer cells.
  • Steroids ; this treatment is used to reduce swelling around the lymphoma and may shrink it. Steroids improve symptoms and help you feel better. If you have raise pressure in the brain, you will be treated with steroids right away.