       Document 0442
 DOCN  M9620442
 TI    [Cerebral toxoplasmosis. Neuroradiologic diagnosis and prognostic
       monitoring]
 DT    9602
 AU    Martin-Duverneuil N; Cordoliani YS; Sola-Martinez MT; Miaux Y; Weill A;
       Chiras J; Neuroradiologie Charcot, Hopital de la Salpetriere, Paris.
 SO    J Neuroradiol. 1995 Sep;22(3):196-203. Unique Identifier : AIDSLINE
       MED/96043316
 AB    Cerebral toxoplasmosis remains the most frequent etiology of cerebral
       masses in AIDS. In most cases, the disclosure of multiple enhanced
       masses is suggestive of diagnosis of toxoplasmosis and leads to
       undertake presumptive therapy. Sometimes, the pattern is less
       suggestive, and the possibility of primary cerebral lymphoma (PCL) is a
       diagnostic dilemma, because this is a short term life-threatening lesion
       in the absence of an undelayed fitting therapy. However, apart from the
       periventricular form of PCL, where directly proceeding to biopsy should
       be suggested, there is no distinctive pattern of PCL. The most reliable
       features in distinguishing between PCL and toxoplasmosis are: solitary
       lesion, homogeneous enhancement of a lesion whose diameter is larger
       than 2 cm, situation in deep periventricular white matter and limited
       edema and mass effect. The presence of haemorrhagic foci in the lesion,
       if there is no steroid therapy is rather indicative of toxoplasmosis.
       The lack of enhancement on enhanced CT-scan does not allow to eliminate
       cerebral toxoplasmosis, and indicate MR examination, or empiric
       antitoxoplasmic treatment. The radiologic follow-up depends on clinical
       response and on initial pattern. The criteria of response to
       antitoxoplasmic treatment are: the decrease in volume or number of
       lesions, the decrease of edematous reaction and mass effect (if no
       steroid was administered). If the lesion was initially equivocal, the
       lack of growth in a 8-day delay is a criterion for toxoplasmosis, just
       as the occurring of haemorrhage in the lesions (if there is no
       steroid-therapy).
 DE    AIDS-Related Opportunistic Infections/*DIAGNOSIS/DRUG THERAPY/
       RADIOGRAPHY  Brain Neoplasms/DIAGNOSIS/RADIOGRAPHY  Cerebral
       Hemorrhage/DIAGNOSIS/RADIOGRAPHY  Cerebral Ventricles/PATHOLOGY
       Diagnosis, Differential  English Abstract  Follow-Up Studies  Human
       Lymphoma, AIDS-Related/DIAGNOSIS/RADIOGRAPHY  *Magnetic Resonance
       Imaging  Prognosis  *Tomography, X-Ray Computed  Toxoplasmosis,
       Cerebral/*DIAGNOSIS/DRUG THERAPY/RADIOGRAPHY  JOURNAL ARTICLE  REVIEW
       REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

