Magnetic resonance as initial screening diagnosis of secondary involvement of central nervous system in NHL diffuse large B cell lymphoma

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Background: Central Nervous System (CNS) relapse in Diffuse Large B-cell Lymphoma occurs mostly 6-8 months after disease onset. This has led to propose that CNS infiltration is an early event in the evolution of the disease. We intend to evaluate the role of magnetic resonance imaging (MR) at diagno...

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Autores principales: Oliver, Ana Carolina, Irigoin, Victoria, Sgarbi, Nicolas, Peixoto, Adriana, Turcatti, Paola, Diaz, Lilian, Zunino, Juan
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2018
Materias:
magnetic resonace
diffuse large B cell lymphoma
central nervous system
resonancia magnética
linfoma difuso de grandes células B
sistema nervioso central
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/17517
Aporte de:
Revistas de la UNC de Universidad Nacional de Córdoba
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institution Universidad Nacional de Córdoba
institution_str I-10
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container_title_str Revistas de la UNC
language Español
format Artículo revista
topic magnetic resonace
diffuse large B cell lymphoma
central nervous system
resonancia magnética
linfoma difuso de grandes células B
sistema nervioso central
spellingShingle magnetic resonace
diffuse large B cell lymphoma
central nervous system
resonancia magnética
linfoma difuso de grandes células B
sistema nervioso central
Oliver, Ana Carolina
Irigoin, Victoria
Sgarbi, Nicolas
Peixoto, Adriana
Turcatti, Paola
Diaz, Lilian
Zunino, Juan
Magnetic resonance as initial screening diagnosis of secondary involvement of central nervous system in NHL diffuse large B cell lymphoma
topic_facet magnetic resonace
diffuse large B cell lymphoma
central nervous system
resonancia magnética
linfoma difuso de grandes células B
sistema nervioso central
author Oliver, Ana Carolina
Irigoin, Victoria
Sgarbi, Nicolas
Peixoto, Adriana
Turcatti, Paola
Diaz, Lilian
Zunino, Juan
author_facet Oliver, Ana Carolina
Irigoin, Victoria
Sgarbi, Nicolas
Peixoto, Adriana
Turcatti, Paola
Diaz, Lilian
Zunino, Juan
author_sort Oliver, Ana Carolina
title Magnetic resonance as initial screening diagnosis of secondary involvement of central nervous system in NHL diffuse large B cell lymphoma
title_short Magnetic resonance as initial screening diagnosis of secondary involvement of central nervous system in NHL diffuse large B cell lymphoma
title_full Magnetic resonance as initial screening diagnosis of secondary involvement of central nervous system in NHL diffuse large B cell lymphoma
title_fullStr Magnetic resonance as initial screening diagnosis of secondary involvement of central nervous system in NHL diffuse large B cell lymphoma
title_full_unstemmed Magnetic resonance as initial screening diagnosis of secondary involvement of central nervous system in NHL diffuse large B cell lymphoma
title_sort magnetic resonance as initial screening diagnosis of secondary involvement of central nervous system in nhl diffuse large b cell lymphoma
description Background: Central Nervous System (CNS) relapse in Diffuse Large B-cell Lymphoma occurs mostly 6-8 months after disease onset. This has led to propose that CNS infiltration is an early event in the evolution of the disease. We intend to evaluate the role of magnetic resonance imaging (MR) at diagnosis to detect early SNC compromise. Materials and Methods: Prospective longitudinal cohort’s study in DGCB patients treated at Hospital de Clínicas between 2013 and 2015. Skull MRI was performed in all patients at diagnosis and lumbar puncture was done according to predefined risk factors. Results: 35 patients were analyzed. Median age: 68 years (24-85 years). Stage III-IV: 62%, 57% good prognosis according to RIPI score and 43% poor prognosis. MRI was performed in all patients, with no pathological findings in any of them. Twenty-one patients fullfilled criteria for cerebrospinal fluid study. Twenty-two patients were studied and received intrathecal methotrexate prophylaxis. Meningeal relapse was observed in a single patient who had negative studies at diagnosis and had received complete prophylaxis at the end of the 6 R-CHOP series. Conclusions: Only one of the 35 patients relapsed in the CNS. This patient had a noral MRI and CSF study at diagnosis and had received prophylaxis with intrathecal chemotherapy. This results lead us to believe that the value of MRI to detect early infiltration in asymptomatic patients at diagnosis is low.
publisher Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2018
url https://revistas.unc.edu.ar/index.php/med/article/view/17517
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first_indexed 2022-08-20T01:24:55Z
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spelling I10-R10-article-175172019-08-20T11:39:05Z Magnetic resonance as initial screening diagnosis of secondary involvement of central nervous system in NHL diffuse large B cell lymphoma Resonancia magnética como screening inicial de diagnóstico de compromiso secundario del sistema nervioso central en LNH difuso de grandes Células B Oliver, Ana Carolina Irigoin, Victoria Sgarbi, Nicolas Peixoto, Adriana Turcatti, Paola Diaz, Lilian Zunino, Juan magnetic resonace diffuse large B cell lymphoma central nervous system resonancia magnética linfoma difuso de grandes células B sistema nervioso central Background: Central Nervous System (CNS) relapse in Diffuse Large B-cell Lymphoma occurs mostly 6-8 months after disease onset. This has led to propose that CNS infiltration is an early event in the evolution of the disease. We intend to evaluate the role of magnetic resonance imaging (MR) at diagnosis to detect early SNC compromise. Materials and Methods: Prospective longitudinal cohort’s study in DGCB patients treated at Hospital de Clínicas between 2013 and 2015. Skull MRI was performed in all patients at diagnosis and lumbar puncture was done according to predefined risk factors. Results: 35 patients were analyzed. Median age: 68 years (24-85 years). Stage III-IV: 62%, 57% good prognosis according to RIPI score and 43% poor prognosis. MRI was performed in all patients, with no pathological findings in any of them. Twenty-one patients fullfilled criteria for cerebrospinal fluid study. Twenty-two patients were studied and received intrathecal methotrexate prophylaxis. Meningeal relapse was observed in a single patient who had negative studies at diagnosis and had received complete prophylaxis at the end of the 6 R-CHOP series. Conclusions: Only one of the 35 patients relapsed in the CNS. This patient had a noral MRI and CSF study at diagnosis and had received prophylaxis with intrathecal chemotherapy. This results lead us to believe that the value of MRI to detect early infiltration in asymptomatic patients at diagnosis is low. Antecedentes: la recaída en el Sistema Nervioso Central (SNC) del Linfoma No Hodgkin Difuso de Grandes Células B ocurre más frecuentemente 6-8 meses del debut de la enfermedad. Esto ha levado a plantear que la infiltración en SNC es un evento temprano en esta enfermedad. Nos proponemos evaluar el valor de la realización de estudio imagenológico por Resonancia Magnética (RM) al debut para detectar compromiso precoz.Materiales y Métodos: estudio longitudinal prospectivo de cohortes en LNH DGCB tratados en el Hospital de Clínicas entre 2013 y 2015. A todos los pacientes se les realizó RM de cráneo al debut y estudio de líquido cefaloraquídeo (LCR) según factores de riesgo predefinidos.Resultados: se analizaron 35 pacientes. Mediana de edad: 68 años (24-85 años). Estadío III-IV: 62%; 57% presentaron buen pronóstico según score RIPI al debut y 43% mal pronóstico. Se realizó RM a todos los pacientes, no habiéndose encontrado hallazgos patológicos en ninguno de ellos. Veintitres pacientes tuvieron criterio de estudio del LCR de los cuales veintidós se estudiaron y recibieron profilaxis con metotrexate intratecal. Se observó recaída meníngea en una única paciente con estudios negativos al debut y profilaxis completa al mes de finalizadas las 6 series de R-CHOP.Conclusiones: de 35 pacientes uno sólo recayó en el SNC; el mismo había recibido profilaxis con quimioterapia intratecal y presentó una RM normal al debut de su enfermedad. Los resultados nos conducen a pensar que el valor de la RM para detectar precozmente infiltración en pacientes asintomáticos al debut es bajo. Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2018-07-27 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf application/vnd.openxmlformats-officedocument.spreadsheetml.sheet application/pdf application/vnd.openxmlformats-officedocument.spreadsheetml.sheet https://revistas.unc.edu.ar/index.php/med/article/view/17517 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 75 No. 2 (2018); 67-71 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 75 Núm. 2 (2018); 67-71 Revista da Faculdade de Ciências Médicas de Córdoba; v. 75 n. 2 (2018); 67-71 1853-0605 0014-6722 10.31053/1853.0605.v75.n2 spa https://revistas.unc.edu.ar/index.php/med/article/view/17517/20273 https://revistas.unc.edu.ar/index.php/med/article/view/17517/26584 https://revistas.unc.edu.ar/index.php/med/article/view/17517/26585 https://revistas.unc.edu.ar/index.php/med/article/view/17517/26586 Derechos de autor 2018 Universidad Nacional de Córdoba

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