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Linfoma cerebral primario

Definición

Es un cáncer de los glóbulos blancos que comienza en el cerebro.

Causas

La causa del linfoma cerebral primario se desconoce.

Las personas con sistemas inmunitarios debilitados están en mayor riesgo de presentar linfoma cerebral primario. Las causas frecuentes de un sistema inmunitario debilitado incluyen: VIH/sida y haber recibido un trasplante de órganos (especialmente de corazón).

El linfoma cerebral primario puede estar ligado al virus de Epstein-Barr (EBV, por sus siglas en inglés), especialmente en personas con VIH/sida. Este es el virus que causa la mononucleosis.

El linfoma cerebral primario es más común en personas entre de 45 a 70 años. La tasa de este linfoma está aumentando. Casi 1500 pacientes nuevos en reciben el diagnóstico de linfoma cerebral primario cada año en los Estados Unidos.

Síntomas

Los síntomas del linfoma cerebral primario pueden incluir cualquiera de los siguientes:

• Cambios en el habla o la visión
• Confusión o alucinaciones
• Convulsiones
• Dolores de cabeza, náuseas o vómitos
• Inclinarse hacia un lado al caminar
• Debilidad en las manos o pérdida de la coordinación
• Insensibilidad al calor, al frío y al dolor
• Cambios en la personalidad
• Pérdida de peso

Pruebas y exámenes

Se pueden realizar los siguientes exámenes para ayudar a diagnosticar un linfoma cerebral primario:

• Biopsia del tumor cerebral
• Tomografía computarizada, tomografía por emisión de positrones o resonancia magnética de la cabeza
• Punción raquídea (punción lumbar)

Tratamiento

El tratamiento principal es con quimioterapia y ciertos anticuerpos monoclonales que son un tipo de proteína de laboratorio para tratar muchas enfermedades incluyendo el cáncer.

Las personas más jóvenes pueden recibir una alta dosis de quimioterapia, seguida de un autotrasplante de células madre.

La radioterapia de todo el cerebro se puede hacer después de la quimioterapia, pero con frecuencia se descarta debido a las complicaciones neurológicas potenciales.

También se puede intentar el refuerzo del sistema inmunitario, como en aquellas personas que tienen VIH/sida o antecedentes de trasplante de órganos.

Expectativas (pronóstico)

Sin tratamiento, las personas con un linfoma cerebral primario sobreviven menos de 6 meses. Con quimioterapia la mitad de los pacientes estará en remisión 10 años después del diagnóstico. La sobrevivencia puede mejorar con un autotrasplante de células madre.

Posibles complicaciones

Dentro de las posibles complicaciones se encuentran:

• Efectos secundarios de la quimioterapia, incluidos conteos sanguíneos bajos
• Efectos secundarios de la radiación, incluso confusión, dolores de cabeza, problemas del sistema nervioso (neurológicos) y muerte tisular
• Retorno (recurrencia) del linfoma

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