Diagnostic modalities and response to treatment of neurolymphomatosis
| Diagnostic/treatment modality . | Group A: literature review with MGH case series (1972-2000), N = 72 . | Group B: literature review, case reports (2001-2008), N = 44 . | Group C: current IPCG case series (1993-2008), N = 50 . |
|---|---|---|---|
| Imaging | |||
| CT | NA | 3/11 (27) | 7/11 (64) |
| MRI | 28/40 (70) | 28/35 (80) | 36/47 (77) |
| FDG-PET | NA | 19/21 (90) | 16/19 (84) |
| CSF cytology | 21/52 (40) | 10/24 (42) | 18/45 (40) |
| CSF PCR gene rearrangement | NA | 2/2 (100) | 3/11 (27) |
| Biopsy of affected nerve | 24/30 (80) | 19/21 (90) | 23/26 (88) |
| Diagnosis established only by autopsy | 33 (46) | 2 (5) | 4 (8) |
| No. of patients treated for NL* | 43 (60) | 34 (77) | 47 (94) |
| IV HD-MTX | 5/43 (12) | 8/34 (23.5) | 23/47 (49) |
| Intra-CSF chemotherapy | 15/43 (35) | 14/34 (41) | 23/47 (49) |
| Radiotherapy | 10/43 (23) | 17/34 (50) | 16/47 (34) |
| Response rate† | 31/43 (72) | 20/34 (58) | 16/35 (46) |
| Diagnostic/treatment modality . | Group A: literature review with MGH case series (1972-2000), N = 72 . | Group B: literature review, case reports (2001-2008), N = 44 . | Group C: current IPCG case series (1993-2008), N = 50 . |
|---|---|---|---|
| Imaging | |||
| CT | NA | 3/11 (27) | 7/11 (64) |
| MRI | 28/40 (70) | 28/35 (80) | 36/47 (77) |
| FDG-PET | NA | 19/21 (90) | 16/19 (84) |
| CSF cytology | 21/52 (40) | 10/24 (42) | 18/45 (40) |
| CSF PCR gene rearrangement | NA | 2/2 (100) | 3/11 (27) |
| Biopsy of affected nerve | 24/30 (80) | 19/21 (90) | 23/26 (88) |
| Diagnosis established only by autopsy | 33 (46) | 2 (5) | 4 (8) |
| No. of patients treated for NL* | 43 (60) | 34 (77) | 47 (94) |
| IV HD-MTX | 5/43 (12) | 8/34 (23.5) | 23/47 (49) |
| Intra-CSF chemotherapy | 15/43 (35) | 14/34 (41) | 23/47 (49) |
| Radiotherapy | 10/43 (23) | 17/34 (50) | 16/47 (34) |
| Response rate† | 31/43 (72) | 20/34 (58) | 16/35 (46) |
Values are no. positive/no. of tests (%). Group A consists of a retrospective case series of 25 patients diagnosed in Massachusetts General Hospital (MGH) and literature review of additional 47 cases that were published together.1 Group B is based on literature review.4,7-41 Group C is the current case series.
NA indicates not available; PCR, polymerase chain reaction; and IV HD-MTX, intravenous high-dose methotrexate.
Some patients were treated by chemotherapy other than high-dose methotrexate.
Includes complete and partial response by clinical improvement or by posttreatment imaging.