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Colamaria A, Leone A, Carbone F, Dallos Laguado YA, Fochi NP, Sacco M, Fesce C, Sanguedolce F, Giordano G, Iaconetta G, Spetzger U, Coppola L, De Santis E, Coppola G, De Notaris M. Primary Anaplastic-Lymphoma-Kinase-Positive Large-Cell Lymphoma of the Central Nervous System: Comprehensive Review of the Literature. J Clin Med 2023; 12:7516. [PMID: 38137585 PMCID: PMC10743784 DOI: 10.3390/jcm12247516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Primary anaplastic-lymphoma-kinase (ALK)-positive large-cell lymphoma of the central nervous system (PCNS ALK-positive ALCL) is a rare entity, with a limited consensus reached regarding its management. While this pathology often presents as solitary lesions, the occurrence of multiple tumors within the brain is not uncommon. The lack of distinctive radiological features poses a diagnostic challenge, leading to delays in initiating targeted therapy. METHODS We conducted a comprehensive literature search, identifying seventeen publications for qualitative analysis. RESULTS The management options and reported patient outcomes in the literature varied significantly, emphasizing the need for a patient-specific approach. The emergence of ALK-specific inhibitors represents a new frontier in this field, demonstrating promising results. CONCLUSION PCNS ALK-positive ALCL necessitates a comprehensive understanding and optimized management strategies. A tailored therapeutic approach, integrating surgical intervention with radiotherapy and chemotherapy, appears pivotal in addressing this pathology. The implementation of a therapeutic protocol is anticipated for further advancement in this field.
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Affiliation(s)
- Antonio Colamaria
- Division of Neurosurgery, Policlinico “Riuniti”, 71122 Foggia, Italy;
| | - Augusto Leone
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
- Faculty of Human Medicine, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Francesco Carbone
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
| | | | - Nicola Pio Fochi
- Division of Neurosurgery, University of Foggia, 71122 Foggia, Italy
| | - Matteo Sacco
- Division of Neurosurgery, “Casa Sollievo della Sofferenza”, 71013 San Giovanni Rotondo, Italy;
| | - Cinzia Fesce
- Hematology Unit, University Hospital, 71122 Foggia, Italy;
| | | | - Guido Giordano
- Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;
| | - Giorgio Iaconetta
- Unit of Anatomy, Pathological Histology and Diagnostic Cytology, Department of Diagnostic and Pharma-Ceutical Services, Sandro Pertini Hospital, 00157 Rome, Italy; (G.I.); (L.C.)
| | - Uwe Spetzger
- Department of Neurosurgery, Städtisches Klinikum Karlsruhe, 76133 Karlsruhe, Germany; (A.L.); (F.C.); (U.S.)
| | - Luigi Coppola
- Unit of Anatomy, Pathological Histology and Diagnostic Cytology, Department of Diagnostic and Pharma-Ceutical Services, Sandro Pertini Hospital, 00157 Rome, Italy; (G.I.); (L.C.)
| | - Elena De Santis
- Department of Anatomical, Histological, Forensic Medicine and Orthopedic sciences, La Sapienza University, 00185 Roma, Italy;
| | - Giulia Coppola
- Department of Radiological, Oncological and Pathological Sciences, La Sapienza University, 00185 Roma, Italy;
| | - Matteo De Notaris
- Department of Neurosurgery, University of Salerno, 84084 Salerno, Italy;
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Bird CE, Traylor JI, Thomas J, Caruso JP, Kafka B, Rosado F, Blackburn KM, Hatanpaa KJ, Abdullah KG. Primary peripheral T-cell central nervous system lymphoma. Surg Neurol Int 2021; 12:465. [PMID: 34621580 PMCID: PMC8492444 DOI: 10.25259/sni_224_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 08/07/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Primary peripheral T-cell central nervous system lymphoma (PCNSL) is a rare, aggressive tumor that arises in the craniospinal axis and has an increased risk in individuals who are immunocompromised. This lesion often mimics other benign and malignant processes on radiographic imaging, leading to misdiagnosis and delays in treatment. We present a case of a patient with a history of Sjögren's syndrome and progressive neurologic symptoms who underwent craniotomy for diagnosis. CASE DESCRIPTION A 61-year-old woman with a history of Sjögren's syndrome, progressive aphasia, left facial droop, and right-sided paresthesias for 4 months presented for evaluation and management. An enhancing, infiltrative lesion in the left frontal lobe with underlying vasogenic edema was appreciated and suggestive of a primary or metastatic neoplasm. The patient underwent an open biopsy for further evaluation of the lesion. Extensive histopathologic evaluation revealed a diagnosis of T-cell PCNSL. The patient was started on induction methotrexate and temozolomide followed by consolidative radiotherapy. CONCLUSION Autoimmune conditions are a risk factor for T-cell PCNSL development. T-cell PCNSL has radiographic and gross histologic features that are consistent with a broad differential, including gliomas and inflammatory processes. Prompt diagnosis and extensive histopathological evaluation is essential to ensure appropriate treatment.
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Affiliation(s)
- Cylaina E. Bird
- Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Jeffrey I. Traylor
- Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Jenna Thomas
- Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - James P. Caruso
- Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Benjamin Kafka
- Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Flavia Rosado
- Department of Pathology The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Kyle M. Blackburn
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Kimmo J. Hatanpaa
- Department of Pathology The University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Kalil G. Abdullah
- Department of Neurological Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
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Splavski B, Muzevic D, Ladenhauser-Palijan T, Splavski B. Primary Central Nervous System Anaplastic Large T-cell Lymphoma. Med Arch 2018; 70:311-313. [PMID: 27703297 PMCID: PMC5034991 DOI: 10.5455/medarh.2016.70.311-313] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 07/15/2016] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Primary central nervous system lymphoma (PCNSL) of T-cell origin is an exceptionally rare, highly malignant intracranial neoplasm. Although such a tumor typically presents with a focal mass lesion. CASE REPORT Past medical history of a 26-year-old male patient with a PCNS lymphoma of T-cell origin was not suggestive of intracranial pathology or any disorder of other organs and organic systems. To achieve a gross total tumor resection, surgery was performed via osteoplastic craniotomy using the left frontal transcortical transventricular approach. Histological and immunohistochemical analyses of the tissue removed described tumor as anaplastic large cell lymphoma of T-cells (T-ALCL). Postoperative and neurological recovery was complete, while control imaging of the brain showed no signs of residual tumor at a six-month follow-up. The patient, who did not appear immunocompromized, was referred to a hematologist and an oncologist where corticosteroids, the particular chemotherapeutic protocol and irradiation therapy were applied. CONCLUSION Since PCNS lymphoma is a potentially curable brain tumor, we believe that proper selection of the management options, including early radical tumor resection for solitary PCNS lymphoma, may be proposed as a major treatment of such a tumor in selected patients, resulting in a satisfactory outcome.
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Affiliation(s)
- Bruno Splavski
- Department of Neurosurgery, "J. J. Strossmayer" University of Osijek School of Medicine, Osijek, Croatia
| | - Dario Muzevic
- Department of Neurosurgery, "J. J. Strossmayer" University of Osijek School of Medicine, Osijek, Croatia
| | - Tatjana Ladenhauser-Palijan
- Division of Hematology, Department of Internal Medicine, "J. J. Strossmayer" University of Osijek School of Medicine, Osijek, Croatia
| | - Brano Splavski
- Division of Ophthalmology, Osijek Clinical Hospital Center, Osijek, Croatia
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