Current strategies in the diagnosis of diffuse large B-cell lymphoma of the central nervous system

Br J Haematol. 2012 Feb;156(4):421-32. doi: 10.1111/j.1365-2141.2011.08928.x. Epub 2011 Nov 11.


Lymphomas can arise within the central nervous system (CNS) as primary CNS lymphoma (PCNSL) typically involving the brain and less often the leptomeninges, eyes, and spinal cord. In contrast to PCNSL, secondary CNS lymphoma (SCNSL) is considered to originate as quasi metastasis from systemic lymphoma spreading to the CNS. Both types of CNS lymphomas are predominantly tumours of the diffuse large B-cell type and represent aggressive diseases necessitating a rapid diagnosis. Following neuroimaging based on magnetic resonance imaging, stereotaxy and histopathological diagnosis of CNS lymphoma currently remain obligatory to plan treatment. However, progress in cytopathological, immunophenotypic, and molecular genetic analyses of the cerebrospinal fluid (CSF) has been achieved recently and potentially will facilitate lymphoma diagnosis in the future. This review describes the diagnostic procedures in patients with suspected CNS lymphomas, primarily PCNSL. In addition to a summary of the standard diagnostic work-up, an overview and discussion of current data on different techniques for evaluation of the CSF in CNS lymphoma are given.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers / cerebrospinal fluid
  • Biopsy
  • Central Nervous System Neoplasms / diagnosis*
  • Cerebrospinal Fluid / cytology
  • Cerebrospinal Fluid Proteins / analysis
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Magnetic Resonance Imaging
  • Neuroimaging
  • Prognosis


  • Biomarkers
  • Cerebrospinal Fluid Proteins