CNS Lymphoma Diagnosis

The following tests and procedures may be used for Primary central nervous system (CNS) lymphoma diagnosis:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Neurological exam: A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam.
  • Slit-lamp eye exam: An exam that uses a special microscope with a bright, narrow slit of light to check the outside and inside of the eye.
  • Vitrectomy: Surgery to remove some or all of the vitreous humor (the gel-like fluid inside the eyeball). The fluid is removed through tiny incisions and then viewed under a microscope by a pathologist to check for cancer cells.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. For primary CNS lymphoma, a CT scan is done of the chest, abdomen, and pelvis (the part of the body between the hips).
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the brain and spinal cord. A substance called gadolinium is injected into the patient through a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • Lumbar puncture: A procedure used to collect cerebrospinal fluid (the fluid in the spaces around the brain and spinal cord) from the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap. Laboratory tests to diagnose primary CNS lymphoma may include checking the protein level in the cerebrospinal fluid.
  • Stereotactic biopsy: A biopsy procedure that uses a computer and a 3-dimensional (3-D) scanning device to find a tumor site and guide the removal of tissue so it can be viewed under a microscope to check for signs of cancer.
  • Complete blood count (CBC) with differential: A procedure in which a sample of blood is drawn and checked for the following:
    • The number of red blood cells and platelets.
    • The number and type of white blood cells.
    • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
    • The portion of the blood sample made up of red blood cells.
  • Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.

Prognosis

The prognosis (chance of recovery) depends on the following:
  • The patient’s age and general health.
  • The level of certain substances in the blood and cerebrospinal fluid (CSF).
  • Where the tumor is in the central nervous system.
  • Whether the patient has AIDS.
Treatment options for central nervous system (CNS) lymphoma depend on the following:
  • The stage of the cancer.
  • Where the tumor is in the central nervous system.
  • The patient’s age and general health.
  • Whether the cancer has just been diagnosed or has recurred (come back).

Staging Primary CNS Lymphoma

When primary CNS lymphoma continues to grow, it usually does not spread beyond the central nervous system or the eye. The process used to find out if cancer has spread is called staging. The following tests and procedures may be used in the staging process:
  • CT scan (CAT scan)
  • Bone marrow aspiration and biopsy
  • Slit-lamp eye exam
  • Vitrectomy
The cancer spreads in the body through blood, lymph system and through tissue. When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor.

Recurrent Primary CNS Lymphoma

Recurrent primary central nervous system (CNS) lymphoma is cancer that has recurred (come back) after it has been treated. Primary CNS lymphoma commonly recurs in the brain or the eye. If you have recently been diagnosed with CSN lymphoma, contact us to request an appointment with our oncology specialists to obtain a second opinion or to learn more about treatment options.