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The Role of Cerebrospinal Fluid Cytokines in the Diagnosis of Lymphoma

Harish Raja, Melissa R Snyder, Patrick B Johnston, Brian P ONeill, Juline N Caraballo, Joseph G Balsanek, Brian E Peters, Paul A Decker and Jose S Pulido


Our objective was to determine if quantification of cytokines from the cerebrospinal fluid (CSF) can be an adjunct in the diagnosis of lymphoma. In this work, we evaluated the role of interleukin (IL)-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), and IL-10/IL-6 to detect central nervous system (CNS) and systemic lymphoma.


Retrospective case series of 22 consecutive patients undergoing neurologic evaluation at Mayo Clinic, Rochester, MN, between 1996 and 2011 Part of the work-up included a diagnostic lumbar puncture. CSF cytokine levels were measured using an electrochemiluminescent enzyme-linked immunosorbent assay (ELISA).


10/22 patients had a diagnosis of lymphoma; 3 of these 10 patients with lymphoma had CNS involvement. The control group comprised 12 patients with final diagnoses, ranging from functional behavioral spells to prostate cancer. Interleukin-8 levels were significantly higher in patients with lymphoma than in the control group (two sample t-test; p=0.009). No significant difference was detected for any of the cytokines between CNS+ lymphoma and the control group. In a subgroup analysis of patients with lymphoma, none of the cytokines demonstrated a significant difference between CNS+ and CNS- disease.


This is the first study to suggest an association between elevated CSF levels of IL-8 and lymphoma. Conclusions are limited by small sample sizes. However, this data supports additional research to elucidate the role of IL-8 as a possible diagnostic marker of lymphoma.