ArticleBrain pathology (Zurich, Switzerland)2018
Diagnostic red flags: steroid-treated malignant CNS lymphoma mimicking autoimmune inflammatory demyelination.
Article in Brain pathology (Zurich, Switzerland), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 45 citations in OpenAlex.
- Minimizing the risks of stereotactic brain biopsy in suspected central nervous system lymphoma: a retrospective database study.Journal of cancer research and clinical oncology · 2026Article
- Complement C4d Informs the Differential Diagnosis of Inflammatory Demyelinating CNS Diseases.Neurology(R) neuroimmunology & neuroinflammation · 2026Article
- Primary large B-cell lymphoma of the central nervous system mimicking inflammatory myelitis at initial presentation.Journal of clinical and experimental hematopathology : JCEH · 2025Article
- Tumefactive Demyelinating Lesion Mimicking Low-Grade Astrocytoma with a T2/FLAIR Mismatch Sign: A Case Report and Review of the Literature.Diagnostics (Basel, Switzerland) · 2025Article
- Indications and Diagnostic Yield of Paraneoplastic and Autoimmune Encephalitis Antibody Testing: A Retrospective Cohort Study.Brain and behavior · 2025Article
- Multiple sclerosis: a practical review for pathologists.Journal of pathology and translational medicine · 2025Article
- Article
- Case Report: Hypothalamic demyelinating lesion preceding lymphoma arising outside the central nervous system.Frontiers in oncology · 2025Article
- Diagnostic uncertainty of steroid-modified Marburg's variant of multiple sclerosis even at autopsy: A case suggesting lymphoma and related myelin loss.eNeurologicalSci · 2024Article
- Histopathological Diagnosis of Primary Central Nervous System Lymphoma after Therapy with Corticosteroids or Anticoagulants.Cancers · 2024Article
- Longitudinally extensive transverse myelitis preceding primary central nervous system lymphoma: Spinal sentinel neuroinflammation.The journal of spinal cord medicine · 2023Article
- CSF interleukin 6 is a useful marker to distinguish pseudotumoral CNS inflammatory diseases from primary CNS lymphoma.Journal of neurology · 2021Article
- Current and emerging therapies for primary central nervous system lymphoma.Biomarker research · 2021Review
- Primary Central Nervous System Lymphoma Mimicking Longitudinally Extensive Transverse Myelitis.The Neurohospitalist · 2021Article
- Inflammatory Brain Lesions as Omen of Primary Central Nervous System Lymphoma: A Case Report and Literature Review.Brain sciences · 2021Article
- Primary Central Nervous System Lymphomas: A Diagnostic Overview of Key Histomorphologic, Immunophenotypic, and Genetic Features.Diagnostics (Basel, Switzerland) · 2020Review
- Extensive subpial cortical demyelination is specific to multiple sclerosis.Brain pathology (Zurich, Switzerland) · 2020Article
- A Case of Multiple Sclerosis-Like Relapsing Remitting Encephalomyelitis Following Allogeneic Hematopoietic Stem Cell Transplantation and a Review of the Published Literature.Frontiers in immunology · 2020Review
- Two cases of primary ocular adnexal lymphomas diagnosed after pre-biopsy corticosteroid treatment using polymerase chain reaction-based gene rearrangement analysis.American journal of ophthalmology case reports · 2019Article
- Vanishing Brain Lesions in a Patient with Vision Loss and Ataxia: A Case of CNS Lymphoma with Corticosteroid Related Regression.Annals of Indian Academy of NeurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 11 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The presence of inflammation and demyelination in a central nervous system (CNS) biopsy points towards a limited, yet heterogeneous group of pathologies, of which multiple sclerosis (MS) represents one of the principal considerations. Inflammatory demyelination has also been reported in patients with clinically suspected primary central nervous system lymphoma (PCNSL), especially when steroids had been administered prior to biopsy acquisition. The histopathological changes induced by corticosteroid treatment can range from mild reduction to complete disappearance of lymphoma cells. It has been proposed that in the absence of neoplastic B cells, these biopsies are indistinguishable from MS, yet despite the clinical relevance, no histological studies have specifically compared the two entities. In this work, we analyzed CNS biopsies from eight patients with inflammatory demyelination in whom PCNSL was later histologically confirmed, and compared them with nine well defined early active multiple sclerosis lesions. In the patients with steroid-treated PCNSL (ST-PCNSL) the interval between first and second biopsy ranged from 3 to 32 weeks; all of the patients had received corticosteroids before the first, but not the second biopsy. ST-PCNSL patients were older than MS patients (mean age: ST-PCNSL: 62 ± 4 years, MS: 30 ± 2 years), and histological analysis revealed numerous apoptoses, patchy and incomplete rather than confluent and complete demyelination and a fuzzy lesion edge. The loss of Luxol fast blue histochemistry was more profound than that of myelin proteins in immunohistochemistry, and T cell infiltration in ST-PCNSL exceeded that in MS by around fivefold (P = 0.005). Our data indicate that in the presence of extensive inflammation and incomplete, inhomogeneous demyelination, the neuropathologist should refrain from primarily considering autoimmune inflammatory demyelination and, even in the absence of lymphoma cells, instigate close clinical follow-up of the patient to detect recurrent lymphoma.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.