Acute Presentation of Primary CNS Lymphoma Mimicking Toxoplasma in HIV Infection

• Published in: Journal of community hospital internal medicine perspectives Vol. 13; no. 6; pp. 17 - 23
• Main Authors: Acharya, Indira, DeBoer, Scott R, Bhansali, Deepty
• Format: Journal Article
• Language: English
• Published: United States Greater Baltimore Medical Center 04-11-2023
• Subjects: Case Report; CNS toxoplasmosis; Chemotherapy; Non-Hodgkin lymphomas; Brain lesions; Primary CNS lymphoma (PCNSL); Space-occupying; Histopathologic confirmation
• ISSN: 2000-9666; 2000-9666
• DOI: 10.55729/2000-9666.1251

Primary CNS lymphoma (PCNSL) accounts for up to 15% of non-Hodgkin lymphomas in HIV patients and is the second most common cause of space-occupying brain lesions in HIV patients after CNS toxoplasmosis. Differentiation of PCNL and CNS toxoplasmosis is crucial as PCNL carries a poor prognosis with survival time of 2-4 months without treatment but can be improved with prompt initiation of chemotherapy. These two entities often present clinically in a similar manner, and conventional imaging can also be a diagnostic challenge due to overlapping imaging characteristics. Thus, definitive diagnosis of PCNSL relies on histopathologic confirmation. Here, we present a case of intracranial lesion that presented acutely in the context of headache and left sided body weakness and was found to have PCNSL.