Controversies in primary CNS lymphoma

Primary CNS lymphoma is a non-Hodgkin's lymphoma confined to the CNS: the brain, eyes and cerebrospinal fluid. Unlike other primary brain tumors, primary CNS lymphoma is uniquely chemo- and radiosensitive. However, the outcome of primary CNS lymphoma patients is significantly inferior to similar non-Hodgkin's lymphoma patients. Multiple prospective studies using high-dose methotrexate, with or without whole-brain radiotherapy, have reported improved primary CNS lymphoma outcome, but numerous questions remain regarding the optimal care of a given patient.