Lymphoma in the brain has a special position among brain tumors. This is because it consists of cells that are not native to the brain. Compared with other brain tumors, brain lymphomas occur relatively rarely. Only three percent of brain tumors are lymphomas.
What is lymphoma in the brain?
Lymphoma in the brain refers to degenerate cells of the immune system. More specifically, it is in the lymphocytes, which belong to the white blood cells. These form a tumor. Normally, lymphomas settle within the lymphatic organs. These include lymph nodes, liver, spleen, and the mucous membranes of the stomach and intestines. However, lymphoma can spread from these organs to the brain, becoming what is known as a secondary brain lymphoma. However, it is also possible for lymphoma to develop in the brain itself. Such a lymphoma is called primary brain lymphoma. This lymphoma in the brain originates in degenerated lymphoid cells.
Causes
Unfortunately, the causes for lymphoma in the brain are not yet known. Thus, the trigger for the degeneration of white blood cells and the associated formation of a tumor in the human brain remains a mystery. However, it can be said that the risk of developing lymphoma in the brain is relatively low in individuals with an intact immune system. In people with a weakened immune system, however, the risk increases dramatically. It has been found that about one percent of people with AIDS develop lymphoma in the brain. Basically, the shorter the duration of the underlying disease, the lower the risk of developing lymphoma in the brain.
Symptoms, complaints, and signs
Lymphoma in the brain can cause a variety of symptoms. These depend on the location and size of the cerebral lymphoma, among other factors. The first signs of illness are often nausea, vomiting, and headache. These symptoms are particularly noticeable in the case of increased intracranial pressure, which occurs in approximately half of those affected. Increased intracranial pressure occurs when cerebral lymphoma spreads to the meninges. This often results in fluid accumulation (cerebrospinal fluid, CSF) in the cerebrospinal fluid chambers. Sometimes paralysis symptoms are observed that affect only one half of the body. This is referred to as hemiparesis. Often, the eyes are also affected, when certain cellular components invade the vitreous body and the middle eye skin. This results in visual field loss or visual acuity loss, which is characterized by partial visual field loss and reduced visual acuity. Half of all patients with cerebral lymphoma develop neuropsychological symptoms such as memory impairment, personality changes, and confusional states. Aphasias (speech disorders) may also occur. Speech disorders are manifested by impairments in language formation and comprehension, among other symptoms. If the lymphoma is located in the temporal lobe, ]]epilepsy|epileptic seizures]] may also occur. However, this is rarely the case. The prognosis of the disease ranges from complete cure to fatal and depends on the type, size, location, and when treatment is started.
Diagnosis and course
Schematic diagram showing the location of a brain tumor in the brain. Click to enlarge. Modern cross-sectional imaging plays a significant role in the diagnosis of lymphoma in the brain. Thus, it is possible to visualize the affected regions with the help of magnetic resonance imaging and computed tomography. However, cross-sectional imaging does not provide a reliable diagnosis. The reason for this is the multiformity of lymphoma in the brain. Additional examinations are necessary. In this context, the examination of the cerebrospinal fluid must be mentioned. However, final certainty with regard to the diagnosis is only given by the fine-tissue examination. Lymphoma in the brain requires diagnosis and treatment as soon as possible, since the tumor usually grows very quickly. The form of therapy is very decisive for the course of the disease. It is therefore chosen carefully by the physicians. As a rule, lymphoma in the brain responds very well to radiotherapy. However, this alone is not enough and the therapy is associated with a great risk.For this reason, a combined version of chemotherapy and radiotherapy is recommended. In such a case, there is a 5-year survival rate of up to 70 percent for lymphoma in the brain.
Complications
Usually, lymphoma in the brain is a very serious complaint. If the tumor is not treated or removed, the patient will die in most cases. For this reason, treatment by a physician is necessary in any case. Patients suffer primarily from headaches, which usually cannot be limited with the help of painkillers. Likewise, it is not uncommon to experience vomiting or nausea. Those affected may also have visual disturbances and are thus significantly restricted in their daily lives. Paralysis and disturbances of sensitivity can also occur due to the lymphoma in the brain in various parts of the body and significantly reduce the patient’s quality of life. It is not uncommon for patients to become disoriented or have memory lapses, making everyday life much more difficult for those affected. Personality disorders or psychological complaints can also occur due to the lymphoma in the brain. Treatment of this complaint is possible through radiation therapy and chemotherapy. This may allow the tumor to be completely removed. However, it is usually not possible to universally predict whether there will be a complete positive course of the disease. Possibly, the patient’s life expectancy will be reduced and limited by the lymphoma in the brain.
When should you see a doctor?
Medical advice is needed if there are signs of lymphoma in the brain. If neurologic deficits, seizures, recurrent migraines, gastrointestinal distress, and other symptoms develop, it is best to see a primary care physician immediately. If symptoms are severe or rapidly increasing and affect well-being, a neurologist should be consulted. If the symptoms occur in connection with a viral infection, the ingestion of certain chemicals, or X-rays or gamma radiation, the appropriate physician must also be informed. Affected individuals should also seek medical advice if severe accompanying symptoms occur, such as headache, nausea and vomiting, or memory impairment. In the event of recurrent epileptic seizures, it is best to call an emergency physician. The actual diagnosis is made by a neurologist, who usually also initiates treatment. Other points of contact are internists and physiotherapists. Since the disease can also affect the psyche, accompanying psychotherapy is useful. After completion of treatment, the sufferer must undergo regular examinations to rule out any recurrences or to be able to treat them promptly.
Treatment and therapy
In the case of lymphoma in the brain, treatment depends on the tumor. If isolated lymphoma is present, a combination of chemotherapy and radiation therapy is usually used. However, early diagnosis is the basis for successful treatment. To prevent the lymphoma from spreading through the cerebrospinal fluid, an additional drug is often given. It is administered via a puncture of the spinal canal. Radiation for lymphoma in the brain is given in single doses and occurs over a period of up to five weeks. Treatment in the form of surgery is not an option for lymphoma in the brain. The reason is that cerebral lymphoma cannot be completely removed in the case of lymphoma in the brain.
Outlook and prognosis
If left untreated, lymphoma in the brain results in the premature demise of the affected person. There is a steady increase in pain or dysfunction as the lymphoma continues to spread unimpeded inside the head. Ultimately, the patient’s organism is weakened to such an extent that death occurs. The prognosis improves if the diagnosis is made early and medical treatment can be initiated. The growth of the lymphoma must be contained as quickly as possible so that there is a chance of cure. Classical cancer therapy is initiated to increase the patient’s chances of survival. Chemotherapy and radiation therapy are used to prevent the diseased tissue from dividing cells. The prospect of improvement is given in people who basically have a healthy immune system.It has been shown that these individuals have a better chance of coping with the disease. Despite regression of the lymphoma, symptoms may recur at any time during life. In these cases, the same treatment measures are taken as for the initial illness. Again, the weaker the immune system, the less favorable the prospects for relief of symptoms. People with lymphoma experience periods of freedom from symptoms. Still, recovery does not occur.
Prevention
There are no universal preventive measures for lymphoma of the brain. However, it is generally recommended to avoid chemicals and unnecessary radiation. In addition, the immune system should be strengthened. A low-fat and varied diet, as well as plenty of exercise and little alcohol are therefore the basis for reducing the risk of developing lymphoma in the brain.
Follow-up
As with all tumor diseases, the first step after treatment is close follow-up. The aim of this is to detect any new tumors or metastases at a very early stage. In the case of a brain tumor, checks are therefore carried out several times a year at intervals of a few months. If no abnormalities are found, the intervals between the next check-ups are increased. Whether there are any new growths is usually checked via MRI or CT. Because malignant brain tumors often have a high risk of recurrence despite initially successful treatment, it is important that those affected keep their follow-up appointments regularly. The prognosis for new tumors is more favorable the earlier they are detected. New brain tumors do not always cause symptoms immediately, which should alert the patient. Often, findings that require treatment are discovered more by chance during follow-up. However, if unusual pain is noticed outside of the follow-up checks, this is always a reason to see the treating physician promptly. He or she can decide whether the next follow-up appointment should be brought forward in order to rule out the possibility that new tumors have formed.
What you can do yourself
Treatment by means of self-help is not possible for this disease. In any case, patients are dependent on radiation therapy or chemotherapy to fight the lymphoma in the brain in this disease. Furthermore, regular medication must also be taken to prevent the disease from spreading through the cerebrospinal fluid. Surgical treatment is not possible in this case. As with other cancers, those affected are dependent on constant support from friends and family. This support should not take place on a physical level, but also on a psychological level. In case of depression or other psychological upsets, conversations with the family or other trusted persons always help. The affected person should be relieved in his everyday life, especially if he has to undergo chemotherapy. Unnecessary stress should be avoided at all costs. Children should always be informed about the possible consequences and complications of lymphoma in the brain. Furthermore, in this disease, contact with other patients can have a positive effect on the course of the disease.
