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Background: Primary central nervous system lymphoma (PCNSL) is a rare and aggressive extranodal non-Hodgkin lymphoma confined to the brain, leptomeninges, spinal cord, or eyes without systemic disease. It represents a small proportion of CNS malignancies, and diffuse large B-cell lymphoma (DLBCL) is the predominant histological subtype. [1, 2]. 

Materials and methods: A retrospective case series of three biopsy-proven PCNSL patients managed between November 2025 and April 2026 was conducted. Clinical presentation, radiological findings, surgical approach, histopathology, and adjuvant treatment were reviewed from institutional records. 

Result: The patients were aged 53 to 72 years. Headache was the most common presenting symptom. Magnetic resonance imaging demonstrated contrast-enhancing lesions with diffusion restriction in all three patients. Two patients underwent stereotactic or neuronavigation-guided biopsy, while one patient underwent subtotal resection. Histopathology confirmed DLBCL in all three cases. All patients were referred for oncological treatment. 

Conclusion: PCNSL should be suspected in patients with enhancing intracranial lesions showing diffusion restriction on MRI. Early tissue diagnosis by stereotactic or navigation-guided biopsy remains essential for definitive diagnosis and initiation of methotrexate-based therapy. [4,5].

Keywords: Primary central nervous system lymphoma; PCNSL; diffuse large B-cell lymphoma; stereotactic biopsy; neuro-oncology.