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Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma
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Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma

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[Clinical Manifestations, Imaging Features and Pathological Diagnosis of Primary Central Nervous System Lymphoma]

Hai-Li Wang1, Zhong-Mian Zhang1

  • 1Department of Oncology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China.

Zhongguo Shi Yan Xue Ye Xue Za Zhi
|February 6, 2018
PubMed

Insights

Primary central nervous system lymphoma (PCNSL) often presents with non-specific symptoms and imaging findings. Biopsy is crucial for accurate diagnosis, with diffuse large B-cell lymphoma being the most common type.

Area of Science:

  • Neurology
  • Oncology
  • Pathology

Background:

  • Primary central nervous system lymphoma (PCNSL) is a rare extranodal non-Hodgkin lymphoma confined to the brain, spinal cord, meninges, or eyes.
  • Clinical presentations and imaging findings of PCNSL can be nonspecific, leading to diagnostic challenges.
  • Accurate and timely diagnosis is essential for appropriate treatment and improved patient outcomes.

Purpose of the Study:

  • To analyze the clinical manifestations, imaging features, and pathological diagnosis of patients with primary central nervous system lymphoma.
  • To identify key diagnostic characteristics that can aid in differentiating PCNSL from other intracranial lesions.

Main Methods:

  • Retrospective analysis of clinical data from 50 patients diagnosed with PCNSL.
  • Evaluation of routine pathology and immunohistochemical staining for all patients.
  • Microvessel density (MVD) and VEGF assessments in 15 patients; 15 glioma patients served as a control group.

Main Results:

  • The study included 50 PCNSL patients, with chronic disease progression and common symptoms including numbness, cognitive impairment, and consciousness disorders.
  • Imaging revealed characteristic findings: 66% showed slightly higher density on CT, 92% had enhanced MRI lesions, and 76% presented with multiple intracranial lesions.
  • Pathological diagnosis confirmed diffuse large B-cell lymphoma in 94% of cases, with a high Ki-67 proliferation index (82% of cases).

Conclusions:

  • Primary central nervous system lymphoma, predominantly diffuse large B-cell lymphoma, often presents with complex clinical and imaging features that lack specificity.
  • A subset of patients may be prone to pathological misdiagnosis, underscoring the critical need for biopsy in definitive diagnosis.
  • Histopathological examination, including immunohistochemistry, remains the gold standard for diagnosing PCNSL.
Abstract

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