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EHA 2026 | Non-biopsy diagnostic strategies for primary CNS lymphoma
Maurilio Ponzoni, MD, of Vita Salute University San Raffaele, Milan, Italy, shares insights into alternative approaches for diagnosing primary central nervous system lymphoma (PCNSL), noting that while stereotactic biopsies are the gold standard, they are not always possible due to anatomical limitations. In that case, Prof. Ponzoni highlights that detecting the MYD88 mutation and elevated IL-10 levels can be useful diagnostic biomarkers, although this doesn’t have 100% accuracy. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
We can try to perform a diagnosis at least in some patients, I would say in the minority of them. So whenever it is possible, the gold standard, as I mentioned earlier, is to perform the stereotactic biopsies because you get the formal proof that there are neoplastic cells there. However, sometimes the anatomical localization does not allow the neurosurgeon to obtain the stereotactic biopsies. In those cases, you can detect the MYD88 mutation together with increased interleukin-10 levels...
We can try to perform a diagnosis at least in some patients, I would say in the minority of them. So whenever it is possible, the gold standard, as I mentioned earlier, is to perform the stereotactic biopsies because you get the formal proof that there are neoplastic cells there. However, sometimes the anatomical localization does not allow the neurosurgeon to obtain the stereotactic biopsies. In those cases, you can detect the MYD88 mutation together with increased interleukin-10 levels. And when these two parameters do occur simultaneously, the chance that the patient may have a primary CNS lymphoma is high. It’s not 100%. So any kind of approach has some pitfalls, so we have to take care of them. So I’m not quite sure that right now these two biomarkers may replace the stereotactic biopsies. But it’s true that you can perform stereotactic biopsies and you cannot perform stereotactic biopsies in some instances in which you can perform that kind of approach.
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