Journal of Surgery Current Trends & Innovations Category: Clinical Type: Review Article

CNS Lymphoma: A Review

MBA1*
1 Department Of Neurological Surgery, California Institute Of Behavioral Neurosciences & Psychology, Fairfield, United States

*Corresponding Author(s):
Dennis Adjepong, MD, MBA
Department Of Neurological Surgery, California Institute Of Behavioral Neurosciences & Psychology, Fairfield, United States
Tel:+1 5712771998,
Email:adjepongdennis1@gmail.com

Received Date: Apr 03, 2020
Accepted Date: May 03, 2020
Published Date: May 11, 2020

Abstract

CNS lymphoma is a rare form of the extra-nodal non-Hodgkin lymphoma that is primarily confined to the brains, the eyes, and the cerebrospinal fluid without any existing knowledge or evidence of a systematic kind of spread. The patient’s prognosis with the illness has, over time, improved notably during the last decade following the introduction of the higher doses of the methotrexate. However, despite this new kind of progress, the results after the treatments are durable in half of the population of those suffering from the disorder. The therapy can, however, be associated with considerably late neurotoxicity.

Keywords

Extra-nodal; Lymphoma; Methotrexate; Neurotoxicity; Non-Hodgkin; Tumor

INTRODUCTION

The CNS lymphoma is considered a rare non-Hodgkin type of lymphoma in which the malignant or the cancer cells from the body lymphoid systems form in the brain and or the spinal cord [1,2]. It can also spread parts of the body [3]. Due to the fact the eye is also located next to the brain, the diseases can even start on the eyes, and this is called ocular lymphoma [4]. Cancer can also involve, in other cases, the spinal fluid that bathes the spinal cord and the brain [5]. This type of lymphoma is termed as the leptomeningeal lymphoma. Both the primary and secondary forms of lymphoma are very are rare. Because the disease is uncommon, the median diagnoses of the disorders stand at 55years [6-8].

Methods

The study includes examining, analyzing, and reviewing the various healthcare journals and article which are related to the disease progression. Because the condition is scarce, it becomes almost impossible to conduct a primary analysis or research from a patient suffering from the condition. The method will, therefore, do a review of the various secondary sources to developed people understanding of the disease [9].

Results

From the review of healthcare journals and articles on CNS lymphoma, the exact cause of the CNS lymphoma has not been established [10-12]. However, according to the various researches conducted, it is believed that multiple factors might increase the overall individual risk factor of the disease [13]. This includes having compromised immunity as a result of HIV or organ transplant [14].

DISCUSSION

Pathophysiology of CNS lymphoma 

Pathology does reveal proliferative cancer cells in an angiogenetic kind of evolution formulae, actively sensitive to the CNS [15]. Several of the CNS lymphoma forms are a large diffuse form of B-cells lymphoma and Burkitt lymphoma. Gene-expression profiling has, in the long run, acknowledged three molecular subsections of CNS lymphoma [16]. This includes germinal center B-cells and activated B-cells. The discoloration of the CNS with antibodies that works to differentiate the CNS subgroups did indicate that the most significant number of the CNS lymphoma forms were not germinal center subtype [17]. The CNS lymphoma is linked with the worse outcomes and frequent type of alterations in the B-cells pathway of receptors. In the same cohort, the B-cells receptor signaling axis with the downstream kind of targets is exaggerated by the actual frequency of the mutation that recur over some time and which are MYD88 and the CD79B.

Biochemistry of lymphoma

The lymphatic system plays a critical role in the body’s immune system. It is made up of spleen, tonsils, and lymph nodes [18]. The immune system also has a white blood cell that is referred to as the lymphocytes. The function of lymphocyte is to fight infections in the organ systems. If the cells become cancerous, they can result in the lymphoma [19]. Lymphoma disease is rare in women than in men, and the prevalence is considerably higher for individuals who have AIDS [20].

Genetics of the disease

The genes implicated in CNS lymphoma progression are IgH,Bcl-6, and TP53 [21]. The precise fundamental source of CNS lymphoma is not adequately understood; yet, individuals with a debilitated immune system or who have their spleen removed have an enlarged peril of evolving complaint [22].

Clinical implication

CNS lymphoma is a rare condition and even more in women in the general population. The impact of the disease very dire. If not adequately dealt with at the right time, the disorders are particularly important in the whole body weakness and can affect the specific areas of the body [23]. The condition is usually associated with severe headaches, seizures, and problems that are related to the vision and the balance of the patient [24]. For most people, the symptom of the disease might include the inability to focus or concentrate on a given aspect of life [25]. The risk of developing a post-transplant lymphoma is higher due to the low immune system that is produced by such activities. In this way, the disorder can result in the death of the patient, especially when the individuals are HIV positive [26].

Scientific analysis of CNS lymphoma

The paper was developed from an article written by Panageas et al., and Karimi et al., [26-28]. The first article by Karimi et al., [28] did highlight much information concerning the disorder but did little in answering the question concerning the treatment and the case of the disease [29]. However, the second article did much on the treatment of the CNS lymphoma. Preference was given to the second article by Karimi et al., [28]. Over the first article since it is more detailed in explaining disease pathophysiology and the future perspectives [30].

Limitation of the study

The answered question, which has not been answered concerning the CNS lymphoma, is the actual cause of the disease [31]. With various researches suggesting the various risk factors of the conditions, the real cause of the disease remains a mystery, with many of the studies indicating the median age for individuals suffering from the disorders stands at 55 years [9]. The prevalence is considerably higher among those who have AIDS; however, the actual cause of the disease is not well known [32,33].

CONCLUSION

The CNS lymphoma is a rare condition or the rare CNS neoplasm. It is, however highest incidence in the older adult and the immunocompromised persons, especially those who have the HIV/AIDS of persons who had transplantation of body organs. In the past, there exists a critical difference in the presentation and the evaluations of the immune-potent patients and those of the immune-compromised patients. The diagnostic pitfalls in this very uncommon tumor can often result in a missed or delayed diagnosis. This often results in delayed management or additional treatment of the disease. Once it is initiated, therapeutic management most often centers on the systematic kind of chemotherapy. The condition does not affect many people all over the world, and the real causal factor is yet to be established.

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Citation: Adjepong D (2020) CNS Lymphoma: A Review. J Surg Curr Trend Innov 4: 033

Copyright: © 2020  Dennis Adjepong, MD, MBA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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