Toxoplasmosis

Findings:

Multiple MR images demonstrate multiple poorly defined enhancing lesions within the frontal lobes and basal ganglia.The lesions are associated with vasogenic edema with mild mass effect.The lesions also demonstrate some decreased patchy T2 signal suggestive of hemorrhagic changes. A mixed pattern of diffusion abnormality is associated with these lesions.

Discussion:

DDx: metastases, abscesses, multifocal glioma, lymphoma

-Most common cause of focal mass in HIV+

nIrregular ring enhancing lesions with edema, 75% involve BG, CM junction, hypometabolic on PET, low CBV on perfusion MR (high in lymphoma), may be restricted diffusion
nArteritis, thrombosis, possible infarcts associated
nRx with pyrimethamine/sulfadiazine, leucovorin
nHAART improves prognosis

BACK TO MAIN PAGE