Department of Neurosurgery, Haaglanden Medical Centre, The Hague, The Netherlands.
Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands.
Acta Neurochir (Wien). 2024 Jun 11;166(1):261. doi: 10.1007/s00701-024-06138-3.
The gold standard for diagnostics in primary central nervous system lymphoma (PCNSL) is histopathological diagnosis after stereotactic biopsy. Yet, PCNSL has a multidisciplinary diagnostic work up, which associated with diagnostic delay and could result in treatment delay. This article offers recommendations to neurosurgeons involved in clinical decision-making regarding (novel) diagnostics and care for patients with PCNSL with the aim to improve uniformity and timeliness of the diagnostic process for patients with PCNSL.
We present a mini review to discuss the role of stereotactic biopsy in the context of novel developments in diagnostics for PCNSL, as well as the role for cytoreductive surgery.
Cerebrospinal fluid-based diagnostics are supplementary and cannot replace stereotactic biopsy-based diagnostics.
Histopathological diagnosis after stereotactic biopsy of the brain remains the gold standard for diagnosis. Additional diagnostics should not be a cause of diagnostic delay. There is currently no sufficient evidence supporting cytoreductive surgery in PCNSL, with recent studies showing contradictive data and suboptimal study designs.
原发性中枢神经系统淋巴瘤（PCNSL）的诊断金标准是立体定向活检后的组织病理学诊断。然而，PCNSL 需要多学科的诊断，这可能导致诊断延迟和治疗延迟。本文为神经外科医生提供了关于（新型）诊断和 PCNSL 患者治疗的临床决策建议，旨在提高 PCNSL 患者诊断过程的一致性和及时性。
我们进行了一项小型综述，讨论了立体定向活检在 PCNSL 新型诊断方法中的作用，以及细胞减灭术的作用。
基于脑脊液的诊断是辅助性的，不能替代基于立体定向活检的诊断。
立体定向活检后进行脑病理诊断仍然是诊断的金标准。额外的诊断不应该是导致诊断延迟的原因。目前没有足够的证据支持 PCNSL 的细胞减灭术，最近的研究显示出相互矛盾的数据和不理想的研究设计。
