Fluorescein sodium-guided biopsy or resection in primary central nervous system lymphomas with contrast-enhancing lesion in MRI.

Abstract

BACKGROUND:

Surgical procedures are critical in making a conclusive histopathological diagnosis of primary central nervous system lymphoma (PCNSL), which typically presents contrast-enhancing lesions in magnetic resonance imaging (MRI). The fluorescein sodium-guided technique could enhance tumor visibility. We reported a series of patients with PCNSL underwent fluorescein sodium-guided surgical procedures.

PATIENTS AND METHODS:

12 patients clinically considered brain tumors underwent fluorescein sodium-guided surgery in Sun Yat-sen University Cancer Center from March 2016 to July 2017. The age of 4 female and 8 male patients ranges from 39 to 62 years. In 4 patients, corticosteroid had been prescribed before surgery due to intracranial hypertension. After injection of low dose of sodium fluorescein (3-5 mg/kg), the lesions with strong fluorescence staining were identified as the target area for biopsy or resection.

RESULTS:

Based on the targeted tissues with bright and homogenous fluorescence staining, all 12 patients were conclusively diagnosed as B cell non-Hodgkin's lymphoma (diffuse large cell). The specificity of the specimens sent for frozen section was 86.4% (19/22). No fluorescein sodium associated side effects were observed.

CONCLUSION:

Fluorescein sodium guided surgery is an effective and safe tool in biopsy or tumor resection in patients suspicious for PCNSL with preoperative MRI presented contrast-enhanced homogenous lesions. Such technique might still be considered in those patients who have been pretreated with corticosteroid.

• Authors: Fu-Hua Lin, Xiang-Heng Zhang, Ji Zhang, Zhen-Qiang He, Hao Duan, Chao Ke, Ke Sai, Xiao-Bing Jiang, Fuad Al-Nahari, Shao-Yan Xi, Yong-Gao Mou
• Journal: Journal of neuro-oncology (J Neurooncol) Vol. 139 Issue 3 Pg. 757-765 (Sep 2018) ISSN: 1573-7373 [Electronic] United States
• PMID: 30117022 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Fluorescein

Topics

• Adult
• Brain Neoplasms (diagnostic imaging, pathology, surgery)
• Contrast Media
• Female
• Fluorescein
• Humans
• Image-Guided Biopsy
• Lymphoma (diagnostic imaging, pathology, surgery)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neurosurgical Procedures
• Surgery, Computer-Assisted