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KMID : 0942820100090020120
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Journal of Korean Brain Tumor Society
2010 Volume.9 No. 2 p.120 ~ p.124
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Diagnosis of Toxoplasmosis which Shows Unusual Findings in FDG-PET in a Patient with HIV-1 Infection
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Lee Myoung-Hee
Son Eun-Ik
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Abstract
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Toxoplasmosis is the most frequent cause of focal brain lesion in patients with acquired immunodeficiency syndrome, and this is followed by primary central nervous system(CNS) lymphoma. It is difficult to differentiate these two etiologies on the basis of imaging studies. We report here on the case of contrast enhancing brain lesion in an African woman who presented with headache. She was diagnosed with human immunodeficiency virus(HIV) infection. The radiological studies revealed one ring enhancing and another homogeneous enhancing lesion on the right frontal cortex. Fluorodeoxyglucosepositron emission tomography(FDG-PET) showed some glucose metabolism in the ring enhancing lesion. Though toxoplasmosis is more prevalent than CNS lymphoma, FDG-PET showed inconsistent findings with known hypometabolism of toxoplasmosis. The diagnosis of toxoplasmosis was confirmed on pathological examination of the specimens that were obtained via neuronavigation guided excisional biopsy. We report here on making the differential diagnosis of focal enhancing lesions which have incongruent image findings in a patient with AIDS.
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KEYWORD
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Human immunodeficiency virus(HIV), Toxoplasmosis, Lymphoma, Differential diagnosis
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