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Management of primary central nervous system lymphoma in children
Lisa Giulino-Roth1, Oussama Abla2, Tracy T Batchelor3,4,5
1Division of Pediatric Hematology/Oncology, Department of Pediatrics, Weill Cornell Medical College, New York, NY.
Insights
A 14-year-old boy was diagnosed with diffuse large B-cell lymphoma (DLBCL) in his left parietal lobe. This rare pediatric brain tumor required specialized treatment considerations.
Area of Science:
- Neuro-oncology
- Pediatric Hematology-Oncology
- Neuropathology
Background:
- Primary central nervous system lymphoma (PCNSL) is rare in children.
- Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of PCNSL.
- Intracranial masses in adolescents can present with non-specific neurological symptoms.
Observation:
- A 14-year-old boy presented with headaches and vomiting.
- Imaging revealed a 2x3 cm left parietal lobe mass.
- Stereotactic biopsy confirmed diffuse large B-cell lymphoma (DLBCL).
Findings:
- Cerebrospinal fluid cytology was negative for malignant cells.
- Bone marrow biopsies were negative, ruling out systemic involvement.
- Positron emission tomography/computed tomography (PET/CT) scan showed no evidence of extranodal disease.
Implications:
- This case highlights the importance of considering DLBCL in the differential diagnosis of pediatric brain tumors.
- The localized nature of the tumor suggests potential for targeted therapy.
- Multidisciplinary management is crucial for optimizing treatment outcomes in pediatric PCNSL.
Abstract:
A 14-year-old boy with no significant past medical history presents with headaches and vomiting and is found to have a 2 × 3-cm left parietal lobe mass. A stereotactic biopsy reveals diffuse large B-cell lymphoma (DLBCL). Cerebrospinal fluid cytology, as well as bone marrow biopsies are negative, and a whole-body positron emission tomography/computed tomography scan does not demonstrate other areas of disease. The primary medical team asks how you would treat this patient.
