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The SBB was diagnostic in 25 patients (96%). Potentially treatable disease was diagnosed in 21 patients (81%), and specific therapy was initiated in 17 patients (65%); 10 patients (39%) were able to complete therapy. The SBB corroborated the clinical diagnosis in 13 (52%) of 25 patients. The group with identical clinical and biopsy-proved diagnoses showed significantly better response to therapy (P = .02), clinical performance (P = .04, and survival after biopsy (P = .01), as compared w ith the group with different clinical and biopsy-proved diagnosis, although no significant difference was found for the degree of immunosuppression. Only completion of the treatment plan increased life expectancy significantly (P = .008). These data sho w that in human immunodeficiency virus-positive patients with brain mass lesions, SBB has a high diagnostic yield. A subgroup of patients will benefit from specific therapy guided by the SBB result. The procedure should, however, be strictly limited to patients able to tolerate specific therapy. |
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acquired immunodeficiency syndrome algorithm brain biopsy brain biopsy,stereotaxic human immunodeficiency virus type 1 life expectancy lymphoma lymphoma involving CNS MRI,abnormal MRI,mass effect on neurologic disease,diagnoses of practice guidelines review article toxoplasmosis,CNS treatment of neurologic disorder
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