Diagnosis
Tests that examine the eyes, brain and spinal cord are used to find and diagnose CNS lymphoma. These tests may include
- Physical exam and history
- Neurological exam to check mental status, coordination, ability to walk normally and how well the muscles, senses and reflexes work
- Slit-lamp eye exam – This test uses a special microscope with a bright, narrow slit of light to check the outside and inside of the eye.
- Vitrectomy – A surgical procedure in which some of the vitreous humor (the gel-like fluid inside the eyeball) is removed and examined under a microscope to check for cancer cells.
- Chest x-ray and CT scans of the chest and abdomen
- MRI scans of the brain and spinal cord
- Blood and urine tests
- Lumbar puncture (or spinal tap)
- Stereotactic biopsy, in which a computer and a three-dimensional scanning device are used to find a tumor and guide the removal of tissue for examination under a microscope to look for cancer cells.
Staging
After CNS lymphoma is diagnosed, a series of tests may be done to determine whether the cancer has spread. The information is then used to stage the disease and plan treatment. At this time, patients may also want to schedule a consultation with an ophthalmologist (eye doctor).
Some tests used to stage CNS lymphoma include:
- CT scan
- PET scan
- Bone marrow aspiration and biopsy
- Slit-lamp eye exam
- Vitrectomy
- Testicular examination in men
Prognostic Factors
There are certain factors that affect prognosis (the chance of recovery) and treatment options for CNS lymphoma. These include
- The patient’s age and overall health
- Performance status
- Lactate dehydrogenase level
- Unusually higher or lower level of certain substances in the blood and cerebrospinal fluid
- Location of the tumor in the central nervous system
- Whether the patient has AIDS
*Information cited from Leukemia & Lymphoma Society under Link