True about primary CNS lymphoma -a) Reticulin staining is doneb) Essentially B cell typec) Have an association with EBVd) Indolent disease with good prognosise) Chemotherapy is highly effective
**Core Concept**
Primary CNS lymphoma (PCNSL) is a rare and aggressive type of non-Hodgkin lymphoma that primarily affects the brain and spinal cord. It is characterized by its unique clinical features, pathophysiology, and treatment challenges.
**Why the Correct Answer is Right**
The correct answer **C** highlights the established association between primary CNS lymphoma and Epstein-Barr virus (EBV). EBV is a herpesvirus that is known to play a role in the development of various lymphomas, including PCNSL. The virus infects B cells, leading to their immortalization and transformation into malignant cells. This association is particularly notable in immunocompromised patients, such as those with HIV/AIDS or organ transplant recipients.
**Why Each Wrong Option is Incorrect**
* **Option A:** Reticulin staining is indeed a diagnostic tool used in the pathology of PCNSL, but it is not the most distinctive feature of this condition.
* **Option B:** While PCNSL is primarily composed of B cells, stating that it is "essentially" B cell type is oversimplified, as there may be some T-cell involvement.
* **Option D:** PCNSL is considered an aggressive disease with a poor prognosis, despite some recent advances in treatment.
* **Option E:** While chemotherapy is a component of PCNSL treatment, stating that it is "highly effective" is inaccurate, as the disease often requires a combination of chemotherapy, radiation therapy, and sometimes autologous stem cell transplantation for optimal management.
**Clinical Pearl / High-Yield Fact**
PCNSL is often misdiagnosed as a brain tumor, such as glioblastoma, due to its similar clinical presentation. A high level of suspicion and prompt diagnostic evaluation, including imaging and cerebrospinal fluid analysis, are essential for accurate diagnosis.
**Correct Answer:** C. Have an association with EBV.