Fluorescein sodium-guided surgery in cerebral lymphoma

• Fluorescein sodium under a dedicated surgical microscope filter may be useful in cerebral lymphoma surgery.
• Cerebral lymphoma is fluorescing intensively.
• One representative case shows correspondence between neuronavigation and fluorescence of the targeted tumor.

ObjectivesGrowth and progress of primary central nervous lymphoma (PCNSL) severely disrupt the blood brain barrier (BBB). Such disruptions can be intraoperatively visualized by injecting fluorescein sodium (FL) and applying a YELLOW 560 nm surgical microscope filter. Here, we report a small cohort of patients with PCNSL that mimicked high grade gliomas (HGG) or cerebral metastases (CM), who had been operated on with the use of FL.Patients and methodsRetrospectively, seven patients with PCNSL were identified, who had been operated on by means of microsurgery after intravenous FL injection. The surgical reports were screened for statements on the grade of fluorescent staining in the tumor area. One representative case was chosen to show the staining under white light as well as under filtered light at different distances to the tumor area.ResultsAll patients had shown bright and homogenous fluorescent staining of the tumor (n = 7. 100%). No adverse effects had been observed.ConclusionSimilar to patients with HGG or CM, patients with PCNSL may benefit from use of FL and the dedicated YELLOW 560 nm filter in open surgery.