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A 33-year-old man with acquired immunodeficiency syndrome had an erosive supraglottic mass visible on CT scans of the neck;biopsy was postponed because of the patient's debilitated condition.Two weeks later,he was admitted with altered mental status;an MR image of the brain obtained at that time showed multiple bilateral mass lesions,the largest of which was 5 cm.Findings on a thallium-201 single-photon emission CT(SPECT)scan of the brain were normal.Ten days later,the patient died and autopsy showed both the neck and the brain lesions to be large-cell lymphoma.This case is counterevidence to the reported 100%sensitivity of thallium-201 brain SPECT for demonstrating lymphoma of the central nervous system. |
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