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Lymphoma in the brain

Find out about lymphoma in the brain and its treatment.

What it is

Lymphoma can start in the brain or spinal cord. This is called primary cerebral lymphoma or primary central nervous system (CNS) lymphoma. Lymphoma is a cancer of the lymphatic system.  

Lymphoma in the brain is rare. Fewer than 1 in 20 (5%) of brain or spinal tumours are primary CNS lymphomas. Most are a type of lymphoma called diffuse large B cell lymphoma. 

Treatment options

These tumours are treated differently to other brain tumours. 


You might have chemotherapy as a drip into your bloodstream. You usually have a combination of different chemotherapy drugs including methotrexate. You have it with a drug called folinic acid to protect your kidneys and reduce side effects. 

You might have methotrexate injected into the fluid around your brain and spinal cord (cerebrospinal fluid or CSF). This is called intrathecal chemotherapy. The drug circulates in the fluid around the bain and spinal cord to reach the lymphoma cells. 

Diagram showing how you have a lumbar puncture

Or you might have the drug injected into the cerebrospinal fluid through a small plastic capsule under the skin of the scalp. This is called a ventricular access device or Ommaya reservoir.

After a number of cycles of chemotherapy, you have a scan to see how well the treatment is working. You may continue with more chemotherapy or have radiotherapy. 


You might have radiotherapy: 

  • if chemotherapy does not control the lymphoma
  • if you are not well enough to have chemotherapy 

You usually have radiotherapy to the whole brain and targeted treatment (boost dose) to the area of lymphoma. 

Coping with lymphoma in the brain

Coping with a diagnosis of cancer can be difficult, both practically and emotionally. It can be especially difficult if you have a rare cancer. Being well informed about your cancer and its treatment can make it easier to make decisions and cope with what happens.

Follow up

You will have regular check ups once you finish your treatment. Your doctor will examine you and ask about your general health.

This is your chance to ask questions and to tell your doctor if anything is worrying you.

How often you have check ups depends on your individual situation.

Research and clinical trials

There may be fewer clinical trials for rare types of cancer than for more common types.

It is hard to organise and run trials for rare cancers. Getting enough patients is critical to the success of a trial. The results won't be strong enough to prove that one type of treatment is better than another if the trial is too small.

The International Rare Cancers Initiative (IRCI) aims to develop more research into new treatments for rare cancers. They are designing trials that involve several countries so that more people will be available to enter trials.

Last reviewed: 
06 Oct 2015
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    M Deckert and others  
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  • Primary brain tumours in adults
    D Ricard and others 
    Lancet. 2012 May 26;379(9830):1984-96

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    Expert Review  Neurotherapeutics 2012 Oct;12(10):1197-206

  • Pathogenesis and management of primary CNS lymphoma
    P Roth and others.  
    Expert Review Anticancer Therapy. 2012 May;12(5):623-33

  • Cancer and its Management (7th edition)
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    Blackwell, 2015

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