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Eight patients had a confirmed diagnosis of toxoplasmosis,six had lymphoma,four had other diagnoses,and two were not evaluable.Seven of eight patients with toxoplasmosis had positron emission tomographic scans; all of these scans showed hypometabolic lesions consistent with a nonlymphoma diagnosis.The six patients with lymphoma all had hypermetabolic lesions on the positron emission tomographic scans.The difference between these two sets of results was statistically significant (P<0.001,Fisher exact test,two-tailed).The anti-Toxoplasma titer was greater than or equal to 1:4 in all patients with confirmed toxoplasmosis who had serologic testing and in three of six patients with lymphoma. Evaluating contrast-enhancing brain lesions in patients with AIDS by using Toxoplasma serologic testing and positron emission tomography can accurately guide therapy and obviate the need for most brain biopsies in these patients.A larger,national,multicenter study is needed to confirm our findings and to determine the effect of earlier diagnosis and treatment on morbidity and mortality in patients with AIDS and primary central nervous system lymphoma. |
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acquired immunodeficiency syndrome
brain biopsy
CAT scan,emission
CAT scan,emission,abnormal
gadolinium
lymphoma
lymphoma involving CNS
MRI
MRI,abnormal
MRI,contrast enhanced
neurologic disease,diagnoses of
serologic testing
toxoplasma complement fixation test
toxoplasmosis,CNS
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