FROM THE DESK OF C E. KOOP MD, Former Surgeon General

 

Primary lymphoma of the brain

Causes and Risks:

This type of brain tumor occurs most frequently in people whose immune response is suppressed. It is a neoplasm that occurs in AIDS patients. The cause of the tumor is unknown, but the Epstein-Barr virus may play a role.

 

Personality changes, seizures , or neurological changes may be the initial symptoms. The tumor may disappear after a few weeks of treatment with steroids, but recurrences of the tumor can occur in 4 to 6 months.

 

Risk factors are AIDS or immuno-suppression from cancer, organ transplant, or treatment of autoimmune disorders . The incidence is 3 out of 1 million people.

 

Symptoms:

personality change

mental status change

changes in speech

weakness in hands

decreased sensation (hot, cold, pain)

seizures

headache

hallucinations

 

Signs and Tests:

Tests that indicate primary lymphoma of the brain include:

a brain biopsy that shows lymphoma

a cranial CT scan that shows brain lesion

CSF total protein , increased

CSF cell count that shows increased white blood cells

 

Treatment:

The recommended treatment is with corticosteroids and radiation therapy . Sometimes chemotherapy is also given. The stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group .

 

Prognosis:

AIDS patients are very susceptible to infection with Pneumocystis carinii pneumonia and other severe infections. These are often the cause of death,