bluuebunny/crossref_metadata_2025_split huggingface dataset:
STMO-11 CLINICAL EFFICACY OF AWAKE SURGERY: ANALYSIS OF 335 CASE ON EXTENT OF RESECTION AND SURVIVAL TIME
Authors: Fukui Atsushi , Muragaki Yoshihiro , Maruyama Takashi , Saito Taiichi , Nitta Masayuki , Tamura Manabu , Tuzuki Syunsuke , Ikuta Soko , Kawamata Takakazu 
Published: December 2019

Abstract

INTRODUCTION
Awake craniotomy (AS) with intraoperative mapping can be compatible to obtain maximal resection and preserve neurological function for glioma surgery. However, there is less evidence to improve overall survival for glioma patients. We compared the long-term outcome of glioma resection during AS and general anesthesia (GA).

METHODS
Continuous 335 patients with newly diagnosed glioma of WHO grade2 (G2) or higher who underwent surgery with intraoperative MRI between 2000 and 2013 were reviewed. Three-dimensional volumetric tumor measurements before and after operation were made. Multivariate analysis was used to evaluate the effect of awake surgery on overall survival (OS).

RESULTS
The mean age of all cases was 46 years, male: female 199: 136, mean preoperative tumor volume (PTV) 44.5cc, mean extent of resection (EOR) 88.31%, and median survival (MST) 82.6 months. MST of G4 was significantly longer in the AS group (AS 38.9 months vs. GA group 22.0 months: p = 0.03), while multivariate analysis showed that age and KPS was a significant prognostic factor, but AS was not. There was no significant difference in the EOR of G3 (AS group 80.1% vs. general anesthesia 84.2%: p = 0.365), and MST was also not significantly different (AS group 134.8 months vs. GA group 117.9 months: p = 0.338). G2 also had no significant difference in the EOR (AS group 84.6% vs. GA group 86.7%; p = 0.92), and MST was also not significantly different (AS group 152.9 months vs. GA group 135.1 months: p = 0.235). Analysis of G2 or G3 showed no significant differences in PTV, KPS, and age at the surgery between two groups.

CONCLUSION
Even if a glioma is located close to or within the eloquent area, AS can lead to EOR and OS equivalent to the removal of the non-eloquent area under GA.
RT-05 THE RESULTS OF GAMMA KNIFE RADIOSURGERY WITH BEVACIZUMAB (AVAGAMMA THERAPY) FOR RECURRENT GRADE II/III GLIOMAS
Authors: Asanome Taku , Sato Kenichi , Takanashi Masami , Ozaki Yoshimaru , Kinoshita Yusuke , Sugio Hironori , Ishida Yuki , Nakamura Hirohiko 
Published: December 2019

Abstract

BACKGROUND
For primary grade II/III glioma, we usually combine radiation therapy and chemotherapy after surgical resection. However, the treatment of recurrent grade II/III glioma is controversial. For lesions that can be safely resected, the second surgery may be optimal, but grade II/III glioma often occurs in or near the eloquent areas, so partial resection is often performed. In such cases, if a second surgery for the recurrent tumor is performed, total resection is often difficult. We have performed gamma knife radiosurgery with concurrent bevacizumab (GKRS with Bev) as salvage therapy for recurrent grade II/III gliomas, which were considered difficult to resect.

OBJECTIVE
To investigate the outcome of GKRS with Bev for recurrent grade II/III gliomas. &lt;Methods&gt; We retrospectively reviewed initial pathological findings, PFS/OS from GKRS with Bev, and OS from initial treatment for 23 cases receiving GKRS with Bev for recurrent grade II/III gliomas at our institution between August 2013 and March 2019.

RESULTS
In the initial pathological findings, grade II were 8 cases (DA: 7, OD: 1), and grade III were 15 cases (AA: 14, AOA: 1). Regarding IDH mutations, in grade II, 3 cases were mutant type, 2 cases were wild type, and 3 cases were unknown. Similarly, in grade III, 5, 6, and 4 cases, respectively. From salvage therapy, PFS was median 6 months in grade II and 8 months in grade III, and OS was median 11 months in grade II and 16 months in grade III. From the initial treatment, OS was median 95 months in grade II, and 38 months in grade III.

CONCLUSION
Because most of our cases were astrocytic tumors, when they relapsed, it seemed that some of them progressed to glioblastoma. Even in these severe cases, GKRS with Bev can play an important role as salvage therapy.
RT-06 PLANNING OF BORON NEUTRON CAPTURE THERAPY (BNCT) USING POSITRON EMISSION TOMOGRAPHY (PET)
Authors: Kawabata Shinji , Takeuchi Koji , Hiramatsu Ryo , Matsushita Yoko , Furuse Motomasa , Wanibuchi Masahiko , Isohashi Kayako , Aihara Teruhito , Ono Koji , Miyatake Shin-Ichi 
Published: December 2019

Abstract
Boron neutron capture therapy (BNCT) is the particle irradiation therapy that the selective radiation for tumor cells is available for theoretically. The role that the amino acid (phenylalanine) PET (18F-BPA-PET) that we used boronophenylalanine (BPA) which is a boron compound for neutron capture reaction as a tracer carries out is major in our BNCT especially for the recent non-craniotomy BNCT, and it covers by treatment, observation from indication. In this report, we introduce this PET as a principal axis about BNCT and a relation of the PET.In our BNCT, we calculated the drug accumulation to the tumor from BPA-PET before neutron irradiation and reflected it for individual treatment. We become able to decide indication of BNCT by using this PET study, and the indication expansion to other systemic cancers including head and neck cancer and lung, liver is now worked on actively. Also, in other irradiation modalities, they make a radiation plan based on PET study, and several reports to try the improvement of results had been present, however, high radiation doses will be “ exposed “ to the lesion showing high accumulation in BPA-PET in BNCT. We determine the neutron exposure time from the dosage for the normal tissue in the actual treatment, but the Lesion / Normal tissue ratio obtained from BPA-PET is reflected by the evaluation of the tumor dose and the following treatment plan. Also, after the treatment, diagnoses of the pathologic condition such as an increase in tumor volume, a recurrence or the radiation necrosis might be difficult, and we found that the PET study was useful in the follow-up stage for the patients with already treated malignant brain tumor.
MPC-12 ACCURACY OF INTRAOPERATIVE SIMPLE FLOW CYTOMETER FOR HIGH GRADE GLIOMA OPERATION COMPARED WITH INTRAOPERATIVE FROZEN DIAGNOSIS
Authors: Asano Kenichiro , Fumoto Toshio , Kamataki Akio , Ogawa Kaoru , Kakuta Kiyohide , Katayama Kosuke , Ohkuma Hiroki , Kurose Akira 
Published: December 2019

Abstract

INTRODUCTION
Intraoperative simple flow cytometer (iFC) was developed in recently, we examined the correlation intraoperative frozen diagnosis (IOFD) and intraoperative frozen section of resection margin (IOFM) to iFC.

METHOD AND MATERIAL
Total 33 cases of high grade glioma patients were underwent operation in April 2017 ~ May 2019, and IOFD and IOFM were compared to iFC. Sample of iFC were retrieved just same parts of IOFM and IOFD. We compared to microscopical findings, MIB-1, malignant index (MI), and MI Level (G0-4).

RESULTS
Accuracy rate of iFC and IOFD in high grade glioma was 84%, and the concordance rate of grading was17.2%. Correlation coefficients between MIB-1 and iFC of IOFD was r=0.5019 P=0.0065. Accuracy rate of IOFM was 46.8%, and concordance rate of grading was 35.5%. Correlation coefficients between MIB-1 and iFC of IOFM was r=0.5899 P=0.0001.

CONCLUSIONS
Although iFC accuracy rates iFC of IOFD and IOFM were high, iFC concordance rates and grade were low. Correlation between MIB-1 and iFC of IOFM was better than that of IOFD. Probably, iFC of IOFD was a little difficult because of sample heterozygosity.
NI-06 MOLECULAR DIAGNOSIS, 11C-METHIONINE UPTAKE AND PROGNOSIS IN GRADE 2 AND 3 GLIOMAS
Authors: Tamura Kaoru , Furuhashi Yaeko , Inaji Motoki , Kobayashi Daisuke , Ogishima Takahiro , Sumita Kazutaka , Tanaka Yoji , Nariai Tadashi , Maehara Taketoshi 
Published: December 2019

Abstract

OBJECT
The revised 2016 WHO Classification of Tumours of the Central Nervous System incorporates genetic alterations into the classification system, with the goal of creating more homogenous disease categories with greater prognostic value. In this study, we reclassified 103 consecutive lower grade gliomas using the revised 2016 WHO classification and examined for 11C-methionine uptake and prognosis.

METHODS
103 consecutive lower grade glioma patients (Grade 2 in 41 patients, Grade 3 in 62 patients) treated at Tokyo Medical and Dental University Hospital from 2000 to 2018 were included in this study. The IDH1/2, ATRX and 1p19q status were analyzed using tumor samples. The tumor-to-normal ratio (T/N) of 11 C-methionine uptake was calculated by dividing the maximum standardized uptake value (SUV) for the tumor by the mean SUV of the normal brain.

RESULT
In the integrated diagnosis, 11 astrocytomas and 17 anaplastic astrocytomas were diagnosed as “IDH-mutant”, while 14 astrocytomas and 29 anaplastic astrocytomas were diagnosed as “IDH-wild”. In the 32 oligodendroglial tumors, 12 oligodendrogliomas and 9 anaplastic oligodendrogliomas were diagnosed as “IDH-mutant and 1p/19q-codeleted”. The concordance rate with 1p19q co-deletion and ATRX retention was 94.7%. The median T/N ratios in oligodendroglial tumors with “IDH-mutant and 1p/19q-codeleted” were 1.83 in Grade 2 and 2.83 in grade 3, which were significantly higher than those in astrocytic tumors with “IDH-mutant” (G2: 1.38, G3:1.62). Kaplan-Meier survival analysis revealed that oligodendroglial tumors with “IDH-mutant and 1p/19q-codeleted” had significantly better outcomes regardless of WHO grade. Overall survival was 90.9% at 5 years and 77.9% at 10 years in oligodendroglial tumors with “IDH-mutant and 1p/19q-codeleted”.

CONCLUSIONS
The results indicated that lower grade glioma categories reclassified with molecular classification correlate with the T/N ratio of methionine and the prognosis.
NI-13 PREDICTION OF PROGNOSIS IN NEWLY DIAGNOSED GLIOBLASTOMA USING MACHINE LEARNING-BASED TEXTURE ANALYSIS OF PREOPERATIVE MRI
Authors: Umehara Toru , Kinoshita Manabu , Sasaki Takahiro , Arita Hideyuki , Yoshioka Ema , Shofuda Tomoko , Hirayama Ryuichi , Kijima Noriyuki , Kagawa Naoki , Okita Yoshiko , Uda Takehiro , Fukai Junnya , Mori Kanji , Kishima Haruhiko , Kanemura Yonehiro 
Published: December 2019

Abstract

INTRODUCTION
Preoperative magnetic resonance imaging (MRI) is a critical modality for the determination of glioblastoma (GBM) treatment strategy, as it is thought to reflect the biology of the tumor to some extent. The authors attempted to predict prognosis of newly diagnosed GBM (nGBM) using machine learning-based texture analysis of preoperative MRI in this study.

METHOD
A total of 160 nGBMs with determined overall survival were collected from Kansai Molecular Diagnosis Network for CNS tumors. Preoperative MRI scans (T1WI, T2WI, and Gd-T1WI) from all cases were semi-quantitatively analyzed leading to acquisition of 489 texture features as explanatory variables using Matlab-based in-house software. Dichotomous overall survival (OS) with a cutoff of 15 months was regarded as the response variable (short or long OS). Lasso regression was employed for feature selection to ensure robustness of the prediction model. One hundred patients were randomly assigned as training dataset (TR), followed by predictive model construction via 5-fold cross-validation. Subsequently, the constructed model was transferred to the remaining 60 patients, which was assigned as test dataset (TD). The survival distribution between populations with predicted short and long OS was compared using log-rank test.

RESULTS
Distributions of the analyzed data were as follows; 53 short OS cases in the TR (53.0%) and 27 cases in the TD (45.0%). As for the result of transfer analysis in TD, 38 cases out of 60 (63.3%) were predicted to be short OS (76.3 % of recall, 54.3% of precision, and 63.5% of F-measure). The population of predicted short OS significantly showed poorer prognosis (median OS 14.0 vs 19.1 months) (p=0.02, log-rank test).

CONCLUSION
Short OS was successfully identified from preoperative MRI with high recall rates with our algorithm. The presented result ensures the potential of machine learning-based texture analysis for prognostic stratification of nGBM.
NI-17 T2-FLAIR MISMATCH SIGN IN DIFFUSE GLIOMA AND DYSEMBRYOPLASTIC NEUROEPITHELIAL TUMOR
Authors: Onishi Shumpei , Yamasaki Fumiyuki , Takano Motoki , Yonezawa Ushio , Sugiyama Kazuhiko , Kurisu Kaoru 
Published: December 2019

Abstract

BACKGROUND
T2-FLAIR mismatch sign was reported as a specific imaging marker for diffuse astrocytoma with IDH-mutant and 1p/19q non-codeletion. However, most of the previous studies for T2-FLAIR mismatch were confirmed only among low grade glioma. The purpose of this study is to assess the T2-FLAIR mismatch sign in supratentorial diffuse glioma, diffuse midline glioma and dysembryoplastic neuroepithelial tumor (DNT) to unveil the exception rules of the sign.

METHODS
In total, 51 patients were included in this study; 33 supratentorial diffuse glioma (18 diffuse astrocytoma with IDH mutant (IDHmut-Noncodel), 12 oligodendroglioma with IDH-mutant and 1p19q codeletion (IDHmut-Codel), 3 diffuse astrocytoma with IDH wildtype (IDHwt)), 18 diffuse midline glioma and 11 DNT. The tumors were evaluated by 2 independent reviewers to assess presence or absence of T2-FLAIR mismatch sign.

RESULT
Ten out of 18 cases of IDHmut-Noncodel presented T2-FLAIR mismatch sign. None of the other supratentorial diffuse glioma (IDHmut-Codel and IDHwt) presented T2-FLAIR mismatch. The T2-FLAIR mismatch sign for IDHmut-Noncodel presented 100% positive predictive values among supratentorial diffuse glioma. However, 8 out of 18 cases of diffuse midline glioma and 8 out of 11 cases of DNT also presented the T2-FLAIR mismatch.

CONCLUSION
The T2-FLAIR mismatch sign was specific marker for IDHmut-NonCodel among supratentorial diffuse glioma. Physicians need to be aware that diffuse midline glioma and DNT could present the T2-FLAIR mismatch sign.
NI-19 USEFULNESS OF AMIDE PROTON TRANSFER IMAGE IN IMAGING DIAGNOSIS OF GLIOMA
Authors: Shirota Masami , Nitta Masayuki , Maruyama Takashi , Saitou Taiichi , Tsuduki Syunsuke , Ikuta Souko , Yoshida Ayako , Abe Kayoko , Abe Kouichirou , Muragaki Yoshihiro , Kawamata Takakazu 
Published: December 2019

Abstract

INTRODUCTION
APT image is one of the imaging methods in MRI, and it is a molecular image that images the concentration of an amide group having an amino acid increasing in a tumor, and is expected to be clinically applied in the imaging diagnosis of glioma. on the other hand, MET-PET is useful for diagnosis of glioma because it is well accumulated in tumor cells. Based on the results of pathological diagnosis, we compared the two and verified that APT image is useful.

METHOD
The study included 36 patients who underwent APT image and MET-PET. (Glioma WHO2016 Grade:GII/III/IV,and Pseudoprogression). MET-PET was administered 370MBq/kg, and the accumulation ratio (TNR) of the tumor part to the normal part was measured. APT image measured APT signal with the region of interest at the tumor site.

RESULTS
APT signal in all 36 cases was correlated with 2.19±0.94 and TNR with 2.61±1.55 (r=0.67,p&lt;0.001).The discrimination accuracy between GII/III/IV and Pseudoprogression by APT signal was 84% sensitivity and 100% specificity at threshold 2.0.GII APT signal 2.30±0.43, TNR 4.02±2.12, GIII APT signal 2.67±0.69, TNR 2.81±0.72, GIV APT signal 2.78±0.61, TNR 3.37±1.28 in grade diagnosis At high grade, APT signal and TNR were high. The APT signal of the oligodendroglioma line (GII/III) was 2.44±0.7, the TNR was 3.78±1.51, the APT signal of the astrocytoma line (GII/III) was 2.69±0.51, and the TNR was 2.43±0.98.The oligodendroglioma lineage was lower in APT signal than the astrocytoma lineage, and the TNR was higher.

DISCUSSION
APT images are non-invasive, can easily provide important information, and have the same diagnostic potential as MET-PET. Although TNR of oligodendroglioma (GII/III) tends to be high, the APT signal which is not affected by the blood-brain barrier is consistent in measurement value and is useful for diagnostic imaging of glioma.
NQPC-05 BEVACIZUMAB AFTER PROGRESSION OF GLIOBLASTOMA PROLONGS PATIENT’S LIVING TIME AT HOME IN THE LAST 90 DAYS
Authors: Matsutani Tomoo , Hirono Seiichiro , Iwadate Yasuo 
Published: December 2019

Abstract
Bevacizumab (Bev) is currently available for recurrent glioblastoma to improve a patient’s quality of life (QoL). To maintain a patient’s daily life activity, Bev is sometimes continued beyond radiographical progression until neurological deteriorations. However, the benefit of continuous use of Bev in its terminal stage is not clarified. To clarify the benefit, we retrospectively analyzed clinical data of glioblastoma patients in the terminal stage. Ninety-five patients, who died by supra-tentorial newly-diagnosed glioblastoma progression from 2008 to 2018, were included. Bevacizumab use in the last 90 days, living time at home or final place of death were retrospectively analyzed. Of 95, twenty-six received Bevacizumab beyond progression in the last 90 days (Bev-group), and 49 did not (non-Bev group). The median overall survival time is not different between both, and the number of patients, who died at home, is seven (26.9%) and six (12.2%), respectively. Mean final administration day from death is 49.2 days and the mean living time at home in the last 90 days is 49.2 days in the Bev group, which is statistically longer than 24.0 days of the non-Bev group (p=0.0016).To continue Bev beyond progression prolongs the living time at home in the last 90 days in glioblastoma patients, and Bev should be considered in its palliative care.
ML-04 PROGNOSTIC SIGNIFICANCE OF IMMUNOHISTOCHEMICAL SUBTYPES BASED ON THE STAGE OF B-CELL DIFFERENTIATION IN PRIMARY CNS LYMPHOMA
Authors: Inoue Akihiro , Kohno Shohei , Matsumoto Shirabe , Suehiro Satoshi , Nishikawa Masahiro , Ozaki Saya , Watanabe Hideaki , Ohnishi Takanori , Kunieda Takeharu 
Published: December 2019

Abstract

PURPOSE
Primary central nervous system lymphoma (PCNSL) has been immunohistochemically classified into two subtypes, germinal center (GC) B-cell and non-GC B-cell, but prognostic impact of these subtypes remains debated. We investigated clinical features and prognostic significance of newly defined immunohistochemical subtypes that were identified by expression patterns of three B-cell differentiation markers in PCNSL. In addition, we analyzed a factor related to responsiveness to high-dose methotrexate (HD-MTX) chemotherapy.

METHODS
Tumors from 32 PCNSL patients were immunohistochemically evaluated regarding expression of CD10, BCL-6, and MUM-1 and classified into subtypes according to the expression patterns of these markers. Clinical features and prognostic outcome of these subtypes were investigated.

RESULTS
Twenty-three patients were treated with HD-MTX-based chemotherapy followed by whole-brain radiation therapy (WBRT), and nine were treated with WBRT alone. Three immunohistochemical subtypes were identified, including A-type expressing CD10, BCL-6, and MUM-1 (12 patients), B-type expressing BCL-6 and MUM-1 (12 patients) and C-type expressing MUM-1 only (8 patients). Response rate in the HD-MTX therapy group was 57.1% (4/7) in A-type, 87.5% (7/8) in B-type, and 75% (6/8) in C-type. C-type with the lowest metabolic activity showed significantly longer overall survival than A-type with the higher uptake of methionine (71.6 versus 39.6 months).

CONCLUSIONS
Immunohistochemical identification of PCNSL based on the B-cell differentiation stage revealed three types of tumors, showing different metabolic activity and survival time. Refined immunohistochemical classification of PCNSL subtypes may become a useful tool for predicting more accurate prognosis and accessing the sensitivity to HD-MTX therapy.
ML-07 R-MPV-A THERAPY FOR PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA IN THE ELDERLY: OUTCOME AND PROBLEM
Authors: Fudaba Hirotaka , Momii Yasutomo , Onishi Kouhei , Asou Daigo , Fujiki Minoru 
Published: December 2019

Abstract

PURPOSE
R-MPV-A therapy has recently been reported to improve the outcomes of primary central nervous system lymphoma (PCNSL). Our patients have received R-MPV-A therapy since 2017 and elderly patients have only been treated with whole brain radiotherapy when they do not show a complete response after induction chemotherapy. We report the therapeutic outcomes and problems of elderly PCNSL patients treated with R-PMV-A.

MATERIALS & METHODS
Eight newly diagnosed PCNSL patients received R-MPV therapy from September 2017 to June 2019. We retrospectively reviewed the cycles of R-MPV therapy, radiotherapy, consolidation high-dose Ara-C (HD-Ara-C) therapy, and the G8 score (a geriatric assessment).

RESULTS
Patients were divided into three groups: Group A (71–75 years; n=2), Group B (76–80 years; n=4), and Group C (&gt;81 years; n=2). All Group A patients finished 5 cycles of R-MPV therapy, showed a complete response, and underwent consolidation HD-Ara-C therapy. Two Group B patients showed a complete response on R-MPV therapy. One of the other patients showed a partial response after 3 cycles of R-MPV therapy, and a &gt;3 kg reduction in body weight. The patient’s G8 score was 12 points. Whole brain radiotherapy (23.4 Gy) was administered followed by local radiotherapy (21.6 Gy). One patient showed a partial response after 7 cycles of R-MPV therapy and started radiotherapy. One Group C patient received radiotherapy after 3 cycles of R-MPV because of a new lesion. The other Group C patient showed acute renal damage after 3 cycles of R-MPV.

CONCLUSION
R-MPV-A therapy was relatively safe for our elderly PCNSL patients. Notably, patients &gt;76 years of age sometimes had severe adverse effect with increased R-MPV cycles. A promising therapeutic strategy based on age and geriatric assessment is needed.
ML-11 DETECTION OF MYD88 MUTATIONS FROM CELL FREE DNA AIDS IN THE DIAGNOSIS OF CENTRAL NERVOUS SYSTEM LYMPHOMAS
Authors: Natsumeda Manabu , Watanabe Jun , Kanemaru Yu , Tsukamoto Yoshihiro , Okada Masayasu , Oishi Makoto , Fujii Yukihiko 
Published: December 2019

Abstract

BACKGROUND
Diagnosis of primary central nervous system lymphomas (PCNSL) can be challenging. We have shown that the detection of MYD88 mutation in cell free DNA (cfDNA) taken from cerebrospinal fluid (CSF) is reliable (JCO Precision Oncology, 2019; Leukemia and Lymphoma, 2019). We report four cases in which detection of MYD88 mutation aided in the diagnosis.

CASE 1
A 67-year-old man with a history of systemic B-cell lymphoma, experienced right hemiparesis. MRI showed a slightly enhancing lesion located in the midbrain. MYD88 L265P mutation was found by digital droplet PCR analysis of cfDNA extracted from CSF. The patient underwent a needle biopsy, and was diagnosed as diffuse large B-cell lymphoma.

CASE 2
A 32-year-old man was diagnosed as having a demyelinating lesion after experiencing severe headaches. A small enhancing lesion was found in the right frontal lobe, and the patient was treated with steroids. The lesions repeatedly disappeared and reappeared and finally, stopped responding to steroids. MYD88 mutation was detected. A biopsy was performed, and the diagnosis was PCNSL.

CASE 3
A 49-year-old man underwent a biopsy for a right frontal lesion after experiencing memory loss; the pathology showed broad T-cell infiltration but only some perivascular B-cells with slight atypia. The patient was tapered off steroids, and the lesion spread rapidly. An open biopsy was performed, but the pathology was not typical for B-cell lymphoma. The patient’s symptoms rapidly worsened, and whole brain irradiation was performed. At recurrence, MYD88 mutation was detected.

CASE 4
An 82-year-old man presented with blurred vision. Vitreous humor biopsy was inconclusive for ocular lymphoma. A head MRI showed an intracranial lesion which spontaneously regressed. MYD88 was detected, and the patient is being closely observed.

CONCLUSION
Detection of MYD88 mutation from cfDNA extracted from CSF can aid in the diagnosis of CNS lymphoma, especially in atypical cases.