Details

Autor(en) / Beteiligte

• Datta, Sayan
• Lee, Rebecca
• Webb, Tom
• Ismail, Azzam
• Jung, Agam

Titel

5 YEARS EXPERIENCE OF PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA (PCNSL): A RETROSPECTIVE PILOT AUDIT

Ist Teil von

• Journal of neurology, neurosurgery and psychiatry, 2015-11, Vol.86 (11), p.e4-e4

Erscheinungsjahr

2015

Quelle

BMJ Journals Archiv - DFG Nationallizenzen

Beschreibungen/Notizen

• IntroductionPrimary Central Nervous System lymphoma (PCNSL) is responsible for 5% of all primary brain tumours within the UK. Barriers to diagnosis include steroid-responsiveness/false-negative biopsy and poor CSF sensitivity. We performed a pilot audit reflecting 5 years experience of PCNSL diagnosis based on criteria derived from 2011 British Neuro-Oncology guidelines.MethodsRetrospective case note and electronic patient record review for patients between 2008 to 2013 with biopsy-proven label of PCNSL. Imaging and staging results were reviewed to exclude secondary/metastatic disease.Results20 patients were identified; median age of 58 and 60% were male. Top three clinical presentations were cognitive, paresis and ataxia. Median duration of symptoms was 21 days (range 3 to 180) and median time to biopsy was 14 days.Pre-biopsy5 patients had negative CSF, 20% had steroids with documented clinical reason, 5% had record of HIV status checked and 88% had CT staging.ConclusionDespite limitations, this audit identified that the majority of these patients received steroids pre-biopsy, but in some cases, this may have reasonably been withheld. There is scope for a diagnostic algorithm to highlight safe withholding of steroids, early HIV testing and appropriate staging investigations, downplaying the importance of CSF sampling.