Experience with surgical treatment in patients with lymphoproliferative lesion in the brain and skull vault bones
The problem of lymphoproliferative lesions of the central nervous system (CNS) is urgent in both patients with immunodeficiency states and those without background systemic pathology in spite of the fact that the statistics vary greatly in these two categories. Despite a wide range of noninvasive diagnostic procedures, it is impossible to obtain a significant confirmation of primary lymphoproliferative CNS lesion in patients with no background systemic manifestations of the disease. Stereotactic biopsy, followed by combination chemo- and radiotherapy in accordance with the existing protocols, is a well-known procedure to treat suspected primary CNS lymphoma. This paper describes 4 cases of primary CNS and skull bone lymphomas in patients operated on for skull bone granuloma (in one case) or rapid progression of focal and global cerebral neurological deficit (in 3 cases). A postoperative histological analysis using the currently available methods revealed lymphoproliferative lesions; in this connection the patients continued treatment by oncologists.