Complex Differential Diagnosis Between Cerebral Toxoplasmosis and Primary CNS Lymphoma in Immunocompromised Patients: The Value of Brain Biopsy.

Matthieu Landart, Bertrand Mathon
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Abstract

We report the case of a 24-year-old woman who received immunosuppressive treatment for systemic lupus erythematosus. In her past medical history, she had been treated for disseminated toxoplasmosis (ocular and cardiac). Four months later, she was hospitalized and treated for a presentation suggestive of cerebral toxoplasmosis. The diagnosis of primary central nervous system lymphoma (PCNSL) was finally made using stereotactic brain biopsy; however, the evolution was rapidly fatal within 6 days after admission. We discuss the challenge of differential diagnosis between cerebral toxoplasmosis and PCNSL in immunocompromised patients and the role of brain biopsy in patient management.

免疫功能低下患者脑弓形虫病和原发性中枢神经系统淋巴瘤的复杂鉴别诊断:脑活检的价值。
我们报告的情况下,24岁的妇女接受免疫抑制治疗系统性红斑狼疮。在她过去的病史中,她曾接受播散性弓形虫病(眼部和心脏)的治疗。4个月后,她因出现脑弓形虫病而住院治疗。最终采用立体定向脑活检诊断原发性中枢神经系统淋巴瘤(PCNSL);然而,在入院后6天内演变迅速致命。我们讨论了在免疫功能低下患者中鉴别诊断脑弓形体病和PCNSL的挑战以及脑活检在患者管理中的作用。
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