Diagnostics and treatment delay in primary central nervous system lymphoma: What the neurosurgeon should know

M. C. Hasner*, M. P. van Opijnen, M. van der Meulen, R. M. Verdijk, S. L.N. Maas, L. C.J. te Boome, M. L.D. Broekman

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Purpose:
The gold standard for diagnostics in primary central nervous system lymphoma (PCNSL) is histopathological diagnosis after stereotactic biopsy. Yet, PCNSL has a multidisciplinary diagnostic work up, which associated with diagnostic delay and could result in treatment delay. This article offers recommendations to neurosurgeons involved in clinical decision-making regarding (novel) diagnostics and care for patients with PCNSL with the aim to improve uniformity and timeliness of the diagnostic process for patients with PCNSL.

Methods:
We present a mini review to discuss the role of stereotactic biopsy in the context of novel developments in diagnostics for PCNSL, as well as the role for cytoreductive surgery.

Results:
Cerebrospinal fluid-based diagnostics are supplementary and cannot replace stereotactic biopsy-based diagnostics.

Conclusion:
Histopathological diagnosis after stereotactic biopsy of the brain remains the gold standard for diagnosis. Additional diagnostics should not be a cause of diagnostic delay. There is currently no sufficient evidence supporting cytoreductive surgery in PCNSL, with recent studies showing contradictive data and suboptimal study designs.

Original languageEnglish
Article number261
Number of pages9
JournalActa Neurochirurgica
Volume166
Issue number1
Early online date11 Jun 2024
DOIs
Publication statusE-pub ahead of print - 11 Jun 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

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