Corticosteroid Use Before Stereotactic Brain Biopsy for Suspected Lymphoma.
Preoperative corticosteroids not associated with lower diagnostic yield in suspected lymphoma biopsy.
Corticosteroid Use Before Stereotactic Brain Biopsy for Suspected Lymphoma.
Primary central nervous system lymphoma (primary central nervous system lymphoma) is a rare, aggressive lymphoma requiring histopathological confirmation for diagnosis.
This study assesses the impact of preoperative corticosteroid therapy on the diagnostic yield of stereotactic brain biopsy in primary central nervous system lymphoma, evaluating steroid timing, dose, duration, and associated postoperative complications.
We retrospectively reviewed 725 patients who underwent stereotactic brain biopsy between 2014 and 2025 to identify 104 patients with pathologically confirmed primary central nervous system lymphoma.
steroids beforehand did not lower how often biopsy confirmed the diagnosis
The overall diagnostic yield was 92.3%.
Yield remained high across intervals between corticosteroid therapy administration and biopsy (<48 hours: 96.4%; 48-72 hours: 91.7%; >72 hours: 100%; P = .658), cumulative dose (≤20 mg: 95.5% [95% CI: 78.2%-99.2%], 21-40 mg: 100% [95% CI: 70.1%-100%], >40 mg: 100% [95% CI: 70.1%-100%]; P = 1.0), and duration (≤5 days: 94.6% [95% CI: 81.8%-99.3%] vs >5 days: 100% [95% CI: 91.8%-100%]; P = 1.0).
Preoperative corticosteroids do not significantly reduce diagnostic accuracy in primary central nervous system lymphoma in our cohort.
These findings support the safe use of corticosteroid therapy for symptom control in suspected primary central nervous system lymphoma with expeditious biopsy.
Optimizing biopsy timing, technique, and coordination among disciplines remains essential to ensure diagnostic success.