Cerebral Toxoplasmosis in a Patient with AIDS on F-18 FDG PET/CT
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CASE REPORT
Cerebral Toxoplasmosis in a Patient with AIDS on F-18 FDG PET/CT Hae Won Kim & Kyoung Sook Won & Byung Wook Choi & Seok Kil Zeon
Received: 12 August 2009 / Revised: 27 October 2009 / Accepted: 23 November 2009 / Published online: 26 February 2010 # Korean Society of Nuclear Medicine 2010
Abstract The distinction between primary central nervous system (CNS) lymphoma and nonmalignant lesions due to opportunistic infections, in particular cerebral toxoplasmosis, is important because of the different treatments involved. A 32-year-old patient with AIDS was hospitalized for intermittent headaches. Brain magnetic resonance imaging (MRI) showed a small well-enhanced nodular lesion in the right frontal lobe. A fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET)/ computed tomography (CT) scan showed moderate FDG uptake in the nodular lesion of the right frontal lobe. We present a case of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS) and the usefulness of F-18 FDG PET/CT in the differential diagnosis of the cerebral toxoplasmosis will be discussed.
several of the neurologic syndromes seen with HIV infection, including HIV encephalopathy and progressive dementia. The central nervous system (CNS) may also be involved with opportunistic infections or malignancies associated with progressive immunosuppression [2, 3]. Toxoplasma gondii causes an opportunistic infection, which most commonly involves the CNS in patients with AIDS [4, 5]. To our knowledge, no positron emission tomography (PET)/computed tomography (CT) finding of the cerebral toxoplasmosis has been reported yet in Korea. We present a case of cerebral toxoplasmosis in a patient with AIDS and the usefulness of fluorine-18 fluorodeoxyglucose (F-18 FDG) PET/CT in the differential diagnosis of the cerebral toxoplasmosis will be discussed.
Keywords FDG . PET . CT . AIDS . Cerebral toxoplasmosis
Case Report
Introduction Acquired immunodeficiency syndrome (AIDS) is a set of symptoms and infections resulting from damage to the human immune system caused by the human immunodeficiency lentivirus-1 (HIV-1). In 2007, an estimated 33.2 million people lived with the disease worldwide, over 2.7 million individuals became newly infected with HIV-1, and approximately 2 million AIDS-related deaths occurred [1]. HIV is neurotrophilic and is involved in the pathogenesis of H. W. Kim : K. S. Won (*) : B. W. Choi : S. K. Zeon Department of Nuclear Medicine, Keimyung University, School of Medicine, 194 Dongsan-Dong, Jung-Gu, Daegu, Korea e-mail: [email protected]
A 32-year-old woman was hospitalized for intermittent headaches for the past 3 months. She had no previous illness history and no abnormal results from neurologic examinations. The HIV and toxoplasma antibody tests were positive. Gadolinium-enhanced brain magnetic resonance imaging (MRI) showed a small well-enhanced nodular lesion with edema in the right frontal lobe (Fig. 1). It was difficult to differentiate cerebral toxoplasmosis from primary CNS lympho
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