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Case Report



Primary Central Nervous System Lymphoma (PCNSL) Type Diffuse Large B Cell in Immunocompetent Patient: A Case Report

Anak Agung Ayu Pramaswari, Anak Agung Ayu Putri Laksmidewi, I Made Oka Adnyana, I Putu Eka Widyadharma.




Abstract
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Primary central nervous system lymphoma (PCNSL) is characterized as an extra-nodal non-Hodgkin lymphoma, which is a rare type of brain tumor. PCNSL often happens in an immunocompromised patient and rarely showed in an immunocompetent patient. This is a case of a 63-year-old man with a supratentorial tumor who first suspected as high-grade astrocytoma and underwent resection for his tumor, and the result showed PCNSL with diffuse large B Cell in histopathology. The patient was then admitted to neurology department for general weakness and mass in his forehead. CT scan and MRI brain examinations revealed a relapsed tumor in his left fronto-temporo-parietal lobe that was surrounded by edema and was enhancing after intravenous contrast administration. Histological and immunochemistry analysis of the resected specimen showed primary diffuse large B-cell lymphoma with CD20 positive. Radiation therapy was applied to the patient without chemotherapy, and at his last follow-up (after fifth radiation), the clinical appearance of the patient is better. The role of radiation probably should be reconsidered for PCNSL tumors.

Key words: Diffuse large B-cell Lymphoma, Immunocompetent, Primary Central Nervous System Lymphoma (PCNSL), Radiotherapy






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