Premium
EBV‐driven primary CNS lymphomas (PCNSLs) are seen in Elderly Patients on a variety of immunosuppressive drugs for a variety of autoimmune/collagen vascular diseases
Author(s) -
KleinschmidtDeMasters Bette K.,
Damek Denise A.,
Dogan Ahmed,
Giannini Caterina
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a391-b
Subject(s) - immunosuppression , medicine , azathioprine , prednisone , immunosuppressive drug , immunology , pathology , transplantation , disease
PCNSLs in elderly persons are usually not mediated by Epstein Barr Virus (EBV), unlike PCNSLs in patients with AIDS or organ transplantation; hence IHC or ISH studies for EBV are not routinely performed. We have encountered patients 65 years or older who had autoimmune polyneuropathy (on CellCept for 3 years), polymyositis (oral prednisone alone for >15 years), rheumatoid arthritis (methotrexate >10 years), myasthenia gravis (azathioprine >10 years), or “senile immunosuppression” who developed multifocal, necrotic, EBV+ PCNSLs. Reducing or withdrawing immunosuppressive medications lead to recovery and regression of the PCNSL in some patients, but not all. The striking feature of this series is the variety of underlying diseases‐‐ and accompanying medications‐‐ that can be associated with EBV‐mediated PCNSLs in the elderly patient. Increased testing of PCNSLs for EBV by IHC or ISH may be warranted in any elderly person on any immunosuppressive medication.