**Core Concept**
Primary CNS Lymphoma (PCNSL) is a rare and aggressive type of lymphoma that arises within the central nervous system (CNS), including the brain and spinal cord. It is typically characterized by its rapid growth and infiltration of lymphoma cells into the brain tissue, leading to significant morbidity and mortality. PCNSL often presents with symptoms of increased intracranial pressure, such as headache and visual disturbances.

**Why the Correct Answer is Right**
PCNSL is often associated with Epstein-Barr virus (EBV) infection and is more common in immunocompromised individuals, such as those with HIV/AIDS or undergoing immunosuppressive therapy. The lymphoma cells in PCNSL typically express surface antigens such as CD19 and CD20, making them targets for rituximab-based therapies. Additionally, PCNSL is often unresponsive to systemic chemotherapy due to the blood-brain barrier, making local therapies such as whole-brain radiation and high-dose methotrexate crucial for treatment.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because PCNSL is indeed more common in immunocompromised individuals, such as those with HIV/AIDS or undergoing immunosuppressive therapy.
**Option B:** This option is incorrect because PCNSL is typically characterized by its rapid growth and infiltration of lymphoma cells into the brain tissue, leading to significant morbidity and mortality.
**Option C:** This option is incorrect because PCNSL often presents with symptoms of increased intracranial pressure, such as headache and visual disturbances.

**Clinical Pearl / High-Yield Fact**
A key clinical correlation for PCNSL is its association with immunocompromised states, such as HIV/AIDS or post-transplant lymphoproliferative disorder. This is a critical consideration for clinicians evaluating patients with unexplained neurological symptoms.

**Correct Answer: D.**