Definition

Lymphomas are cancers of the lymph system. The lymph system is a series of nodes, channels, and tissue throughout the body. There are different types of lymphomas. The lymphomas terms discussed here include:

• Primary central nervous system (CNS) lymphomas—occurs in the brain and/or spinal cord.
• AIDS-related primary CNS lymphoma—occurs in people with HIV. It is one of the complications that show that AIDS has developed.

AIDS-related primary CNS lymphoma is a type of non-Hodgkin lymphoma (NHL). NHL can be more aggressive in people with AIDS.

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Causes

Lymphoma starts because of DNA damage in a new white blood cell. The damaged cell divides and grows in an abnormal way. This in turn creates more damaged cells. The cells can form a tumor and invade nearby tissue. The cancer can also spread to other areas of your body. It is not clear what causes the change to DNA. It may be a combination of genetics and factors in your environment.

Risk Factors

Having HIV infection increases the risk of AIDS-related primary CNS lymphoma.

HIV damages the white blood cells in the body. The body will need to make more white blood cells to replace the damaged cells. This increases the chance that a white blood cell with damaged DNA can develop.

HIV also lowers the immune system. This makes people more vulnerable to cancer in general.

Symptoms

Cancer growth can put pressure on tissue around it. It can cause swelling that also puts pressure on brain tissue. Brain tissue, nerves, and the spinal cord can all be affected. This will cause a wide range of symptoms. Some examples include:

• Nausea and vomiting
• Limb weakness or pain
• Headaches
• Hearing or vision problems
• Back pain
• Seizures
• Difficulty swallowing
• Difficulty controlling the flow of urine
• Changes in alertness
• Paralysis

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done. A basic check of your nervous system or an eye exam may be done if you have certain symptoms.

The doctor may test fluids to look for signs of lymphoma. This can be done with:

• Blood tests
• Lumbar puncture—to tests fluids around the spinal cord and brain

A biopsy may be done if a tumor is found. A small sample of the growth will be removed. It will then be closely examined to make a diagnosis.

Images of the spine and brain may also be taken. They can help to find tumors and see what tissue is affected. Images can be taken with:

• MRI scan
• PET scan

Tests will help to determine the stage of the cancer. Staging is based on how far the cancer has spread and what body parts are affected. This will help to make a treatment plan

Treatment

Treatment depends on the type and stage of the cancer. Your care plan will also depend on how aggressive your cancer is. Treatment for HIV infection will start or continue as well.

Cancer treatments can weaken the immune system even more. It is important to manage the HIV infection and keep the immune system as strong as possible. Treatment for HIV includes highly active antiretroviral therapy (HAART). These medicines can improve the immune system. Chemotherapy medicine can interfere with some AIDS medicine. Your care team may need to adjust medicine during treatment.

Treatment for the lymphoma may include:

Prevention

There are no specific steps to prevent this type of cancer. Follow your HIV or AIDS care plan. It may help to keep the immune system strong and decrease the risk of certain cancers.