Linfoma primario del sistema nervioso central en un paciente con sida
Palabras clave:
LINFOMA, SISTEMA NERVIOSO CENTRAL, INFECCIONES POR VIH
Resumen
Se presenta un caso clínico de linfoma primario del sistema nervioso central (LPSNC) en una paciente con infección por virus de la inmunodeficiencia humana (VIH) en estadio sida.
En este caso particular se destaca la confirmación por histopatología mediante intervención neuroquirúrgica de una lesión ocupante de espacio (LOE), lo que permitió instalar tratamiento oncoespecífico y terapia antirretroviral, lográndose buena evolución clínica.
El objetivo de la presente comunicación es realizar una revisión y actualización bibliográfica del LPSNC en pacientes VIH destacando principalmente el aporte de los métodos diagnósticos y terapéuticos.
Citas
1) Simpson M, Berger J. Manifestaciones neurológicas de la infección por virus de inmunodeficiencia humana. Clin Med North Am 1996; 6: 1333-66.
2) Clotet B, Abós J, Andreu D, Ferré C, Gómez X, Graus F, et al. Actitud diagnóstica ante los principales síndromes clínicos en los pacientes infectados por VIH. In: Guía práctica del SIDA. 6 ed. Barcelona: Masson, 2000: 201.
3) Ammassari A, Cingolani A, Pezzotti P, De Luca D, Murri R, Giancola M, et al. AIDS-related focal brain lesions in the era of highly active antiretroviral therapy. Neurology 2000; 55(8): 1194-200.
4) Kirk O, Pedersen C, Cozzi-Lepri A. Non-Hodgkin lymphoma in HIV infected patients in the era of highly active antiretroviral therapy. Blood 2001; 98: 3406-12.
5) Cingolani A, De-Luca A, Larocca L, Ammassari A, Scerrati M, Antinori A, et al. Minimally invasive diagnosis of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. J Natl Cancer Inst 1998; 90(5): 364-9.
6) Savio E, Krygier G, Mirazzo I, Muse I, Braselli A, Purtscher H, et al. Neoplasias asociadas al SIDA. Rev Med Uruguay 1992; 8: 38-43.
7) Fine H, Mayer R. Primary central nervous system lymphoma. Ann Intern Med 1993; 119: 1093-104.
8) Johnson B, Fram E, Johnson P, Jacobowitz R. The variable MR appearance of primary lymphoma of the central nervous system: comparisson with histopathologic features. Am J Neuroradiol 1997; 18: 563-73.
9) Licho R, Litofsky N, Senitko M, George M. Inaccuracy of TI-201 brain SPECT in distinguishing cerebral infections from lymphoma in patients with AIDS. Clin Nucl Med 2002; 27: 81-6.
10) Antinori A, De-Rossi G, Ammassari A, Cingolani A, Murri R, Di Giuda D, et al. Value of combined approach with thallium-201 single photon emission computed tomography and Epstein-Barr virus DNA polymerase chain reaction in CSF for the diagnosis of AIDS-related primary CNS lymphoma. J Clin Oncol 1999; 17(2): 554-60.
11) Antinori A, Cingolani A, De-Luca A, Gaidano G, Ammassari A, Larocca L, et al. Epstein-Barr virus in monitoring the response to therapy of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. Ann Neurol 1999; 45(2): 259-61.
12) Bossolasco S, Nilsson A, de-Milito A, Lazzarin A, Linde A, Cinque P, et al. Soluble CD23 in cerebrospinal fluid: a marker of AIDS-related non-Hodgkin’s lymphoma in the brain. AIDS 2001; 15: 1109-13.
13) Antinori A, Ammassari A, De-Luca A, Cingolani A, Murri R, Scoppettuolo G, et al. Diagnosis of AIDS-related focal brain lesions: a decision-making analysis based on clinical and neuroradiologic characteristics combined with polymerase chain reaction assays in CSF. Neurology 1997; 48: 687-94.
14) Skolasky R, Dal-Pan G, Olivi A, Lenz F, Abrams R, McArthur J. HIV-associated primary CNS lymorbidity and utility of brain biopsy. J Neurol Sci 1999; 163: 32-8.
15) Cordero E, Lara C, Canas E, Romero J, Trujillo F, Chinchon I, et al. Usefulness of cerebral biopsy in focal cerebral lesions in patients with human immunodeficiency virus infection. Med Clin (Barc) 1996; 107: 738-41.
16) Hoffmann C, Tabrizian S, Wolf E, Eggers C, Stoehr A, Plettenberg A, et al. Survival of AIDS patients with primary central nervous system lymphoma is dramatically improved by HAART-induced immune recovery. AIDS 2001; 15: 2119-27.
17) Guha-Thakurta N, Damek D, Pollack C, Hochberg F. Intravenous methotrexate as initial treatment for primary central nervous system lymphoma: response to therapy and quality of life of patients. J Neurooncol 1999; 43(3): 259-68.
18) Krygier G, Sosa A, Lombardo K, Ocampo R, Suarez P, Muse I. AIDS associated tumors: surveillance of 39 patients. World STI/AIDS Congress, 8. Punta del Este, 2003: 226. (Abstract nº 235).
2) Clotet B, Abós J, Andreu D, Ferré C, Gómez X, Graus F, et al. Actitud diagnóstica ante los principales síndromes clínicos en los pacientes infectados por VIH. In: Guía práctica del SIDA. 6 ed. Barcelona: Masson, 2000: 201.
3) Ammassari A, Cingolani A, Pezzotti P, De Luca D, Murri R, Giancola M, et al. AIDS-related focal brain lesions in the era of highly active antiretroviral therapy. Neurology 2000; 55(8): 1194-200.
4) Kirk O, Pedersen C, Cozzi-Lepri A. Non-Hodgkin lymphoma in HIV infected patients in the era of highly active antiretroviral therapy. Blood 2001; 98: 3406-12.
5) Cingolani A, De-Luca A, Larocca L, Ammassari A, Scerrati M, Antinori A, et al. Minimally invasive diagnosis of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. J Natl Cancer Inst 1998; 90(5): 364-9.
6) Savio E, Krygier G, Mirazzo I, Muse I, Braselli A, Purtscher H, et al. Neoplasias asociadas al SIDA. Rev Med Uruguay 1992; 8: 38-43.
7) Fine H, Mayer R. Primary central nervous system lymphoma. Ann Intern Med 1993; 119: 1093-104.
8) Johnson B, Fram E, Johnson P, Jacobowitz R. The variable MR appearance of primary lymphoma of the central nervous system: comparisson with histopathologic features. Am J Neuroradiol 1997; 18: 563-73.
9) Licho R, Litofsky N, Senitko M, George M. Inaccuracy of TI-201 brain SPECT in distinguishing cerebral infections from lymphoma in patients with AIDS. Clin Nucl Med 2002; 27: 81-6.
10) Antinori A, De-Rossi G, Ammassari A, Cingolani A, Murri R, Di Giuda D, et al. Value of combined approach with thallium-201 single photon emission computed tomography and Epstein-Barr virus DNA polymerase chain reaction in CSF for the diagnosis of AIDS-related primary CNS lymphoma. J Clin Oncol 1999; 17(2): 554-60.
11) Antinori A, Cingolani A, De-Luca A, Gaidano G, Ammassari A, Larocca L, et al. Epstein-Barr virus in monitoring the response to therapy of acquired immunodeficiency syndrome-related primary central nervous system lymphoma. Ann Neurol 1999; 45(2): 259-61.
12) Bossolasco S, Nilsson A, de-Milito A, Lazzarin A, Linde A, Cinque P, et al. Soluble CD23 in cerebrospinal fluid: a marker of AIDS-related non-Hodgkin’s lymphoma in the brain. AIDS 2001; 15: 1109-13.
13) Antinori A, Ammassari A, De-Luca A, Cingolani A, Murri R, Scoppettuolo G, et al. Diagnosis of AIDS-related focal brain lesions: a decision-making analysis based on clinical and neuroradiologic characteristics combined with polymerase chain reaction assays in CSF. Neurology 1997; 48: 687-94.
14) Skolasky R, Dal-Pan G, Olivi A, Lenz F, Abrams R, McArthur J. HIV-associated primary CNS lymorbidity and utility of brain biopsy. J Neurol Sci 1999; 163: 32-8.
15) Cordero E, Lara C, Canas E, Romero J, Trujillo F, Chinchon I, et al. Usefulness of cerebral biopsy in focal cerebral lesions in patients with human immunodeficiency virus infection. Med Clin (Barc) 1996; 107: 738-41.
16) Hoffmann C, Tabrizian S, Wolf E, Eggers C, Stoehr A, Plettenberg A, et al. Survival of AIDS patients with primary central nervous system lymphoma is dramatically improved by HAART-induced immune recovery. AIDS 2001; 15: 2119-27.
17) Guha-Thakurta N, Damek D, Pollack C, Hochberg F. Intravenous methotrexate as initial treatment for primary central nervous system lymphoma: response to therapy and quality of life of patients. J Neurooncol 1999; 43(3): 259-68.
18) Krygier G, Sosa A, Lombardo K, Ocampo R, Suarez P, Muse I. AIDS associated tumors: surveillance of 39 patients. World STI/AIDS Congress, 8. Punta del Este, 2003: 226. (Abstract nº 235).
Publicado
2005-03-31
Cómo citar
1.
Cabrera S, Krygier G, Dutra A, Sosa A, Lombardo K, Savio E, Salamano R, Wajskopf S, Mañana G. Linfoma primario del sistema nervioso central en un paciente con sida. Rev. Méd. Urug. [Internet]. 31 de marzo de 2005 [citado 15 de noviembre de 2024];21(1):68-4. Disponible en: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/837
Sección
Casos Clínicos
