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Type:
Educational Exhibit
Keywords:
CNS, Neuroradiology brain, Oncology, MR, Education, Treatment effects, Imaging sequences, AIDS, Lymphoma, Infection
Authors:
M. Dugova, N. Gorlova; Moscow/RU
DOI:
10.1594/ecr2017/C-1881
Learning objectives
Human immunodeficiency virus (HIV)-associated central nervous system (CNS) lymphoma is a diffuse,
large-cell non-Hodgkin lymphoma of B-cell origin that usually occurs in the brain (rarely in the spinal cord).
It is a late complication of HIV infection.
Epstein-Barr virus (EBV) is identified in almost all cases.
Primary CNS lymphoma accounts for roughly 4% of primary brain tumors and 1% of all non-Hodgkin lymphoma.
Toxoplasmosis is the most common central nervous system infection in patients with the acquired immunodeficiency syndrome (AIDS) who are not receiving appropriate prophylaxis .
This infection has a worldwide distribution and is caused by the intracellular protozoan parasite,
Toxoplasma gondii.
Immunocompetent persons with primary toxoplasmosis are usually asymptomatic,
and latent infection can persist for the life of the host.
In immunosuppressed patients,
especially patients with AIDS,
the parasite can reactivate and cause disease,
usually when the CD4 count falls below 100 cells/microL.
Diagnosis toxoplasmosis is a challenge as on cranial imaging,
it closely mimics central nervous system lymphoma.
Interpretation of MR research is of great importance in the differential diagnosis between toxoplasmosis and lymphoma in HIV patients,
because of the different treatment strategies.