Primary central nervous system lymphoma laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]

Overview

Laboratory tests performed in a case suspected of primary central nervous system lymphoma include complete blood count, complete metabolic panel, lactate dehydrogenase, serological testing for HIV, and CSF analysis. Laboratory findings consistent with the diagnosis of primary central nervous system lymphoma include elevated protein and decreased glucose on CSF analysis. Positive EBV DNA in CSF-PCR is helpful for diagnosis of primary central nervous system lymphoma, particularly in HIV/AIDS patients.

Laboratory Findings

Laboratory tests performed in a case suspected of primary central nervous system lymphoma include complete blood count, complete metabolic panel, lactate dehydrogenase, serological testing for HIV, and CSF analysis.

CSF Analysis

• CSF examination demonstrates elevated protein and decreased glucose.
• Positive cytology is uncommon (~25%).
• Positive EBV DNA in CSF-PCR is helpful for diagnosis of primary central nervous system lymphoma, particularly in HIV/AIDS patients.

EBV DNA in CSF

• EBV has been consistently associated with PCNSL in HIV patients.
• The presence of EBV DNA in the CSF detected by PCR in HIV patients with focal brain lesions has been studied as a potential minimally invasive technique to diagnose PCSNL.
• HIV patients with focal brain lesions with mass effect and positive toxoplasmosis serology should be treated with empiric antibiotics for toxoplasmosis for 10–14 days.

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