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Apparent Spontaneous Regression Of Aids-related Primary Cns Lymphoma Mimicking Resolving Toxoplasmosis

Terriff et al., 1992Lymphoma

Terriff, B. A., Harrison, P., & Holden, J. K. (1992). Apparent spontaneous regression of AIDS-related primary CNS lymphoma mimicking resolving toxoplasmosis. Journal of acquired immune deficiency syndromes, 5(9), 953–954. https://doi.org/10.1016/s0140-6736(17)30056-9

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Case Details

Disease Location

Cns

Personal Characteristics

34 -year-old male 1 year history of aids

Clinical Characteristics

Patient had a double-dose delayed CT scan performed for left-sided patientosis and right-sided weakness the CT demonstrated a single 2.7cm ring-enhancing lesion in the inferior thalamus with extension into the left upper midbrain and cerebral peduncle he was treated with pyearsimethamine, sulfadiazine, and calcium leucovorin for toxoplasmosis repeat CT was performed 2 weeks later with marked reduction in lesion size 4 weeks later, another CT demonstrated a ring enhancing lesion in the same location that measured 3cm he stopped treatment and died 5 weeks later, autopsy showed a highly necrotic immunoblastic lymphoma with viable cell sonly in the periphery of the lesion with no evidence of toxoplasmosis

Remission Characteristics

After initial treatment, he was clinically mildly improved. A repeat ddd CT scan performed 2 weeks later showed a marked reduction in the enhancing ring and a decrease in the sie of the central area of low attenuation visible regression may have been due to massive necrosis

Treatment & Mechanisms

Proposed Remission Mechanisms

No major mechanism proposed

Clinical Treatment

Pyearsimethamine, sulfadiazine, and calcium leucovorin

Non-Clinical Treatment

None reported