5-aminolaevulinic acid-induced fluorescence in primary central nervous system lymphoma.

5-aminolaevulinic acid-induced fluorescence in primary central nervous system lymphoma.

World Neurosurg. 2016 Nov 9;:

Authors: Evers G, Kamp M, Warneke N, Berdel WE, Sabel M, Stummer W, Ewelt C

Abstract
Diagnosis of primary central nervous system lymphoma (PCNSL) is usually confirmed by brain biopsy and subsequent neuropathological work-up.5-aminolevulinic acid-induced fluorescence (5-ALA) has been established for diagnostic and therapeutic purposes in glioma treatment during the last few years and is discussed for use in other cranial tumors. Its role in diagnosis and treatment of PCNSL is still elusive. This retrospective study includes clinical, MRI, pathological and surgical data of selected 11 patients with PCNSL at two University hospitals within the last 4 years undergoing surgical treatment for resection because of imminent mass effect and/or suspected cerebral glioma. Patients received 5-ALA for fluorescence guided resection preoperatively. The 11 subjects aged 59 to 81 years and postsurgical pathological work-up revealed malignant B-cell lymphoma with morphological features of diffuse large B-cell lymphoma (DLBCL). 8 out of these 11 patients with PCNSL showed a clear fluorescence induced by 5-ALA. After surgical resection, patients were treated by combination chemotherapy regimens. In glioma patients the use of 5-ALA is known to be associated with increased extent of resection and survival benefit. Our data and retrospective analysis of a larger patient cohort suggest that the use of 5-ALA in PCNSL patients should be included in a surgical approach, if this is reconsidered for selected patients within a clinical study. In addition, even photodynamic therapy in combination with 5-ALA might be studied.

PMID: 27838426 [PubMed - as supplied by publisher]

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