Case Report

Primary central nervous system lymphoma presenting as multiple space-occupying lesions in advanced human immunodeficiency virus infection

Sara Zafar, Maria Javed, Neesha Rockwood, Farhat Kazmi
South African Journal of Radiology | Vol 21, No 2 | a1234 | DOI: https://doi.org/10.4102/sajr.v21i2.1234 | © 2017 Sara Zafar, Maria Javed, Neesha Rockwood, Farhat Kazmi | This work is licensed under CC Attribution 4.0
Submitted: 04 June 2017 | Published: 14 November 2017

About the author(s)

Sara Zafar, Radiology Department, Chelsea and Westminster Hospital, United Kingdom
Maria Javed, Radiology Department, Chelsea and Westminster Hospital, United Kingdom
Neesha Rockwood, Department of HIV, Chelsea and Westminster Hospital, United Kingdom
Farhat Kazmi, Radiology Department, Chelsea and Westminster Hospital, United Kingdom

Abstract

A 31-year-old man presented with seizures and cerebellar symptoms on a background of weight loss and lethargy. He was found to be infected with human immunodeficiency virus (HIV) and following radiological imaging, was commenced on treatment for presumed cerebral toxoplasmosis. Due to a lack of response, both clinically and on interval imaging, a positron-emission tomography-computed tomography and brain biopsy were undertaken, which demonstrated high-grade primary central nervous system lymphoma (PCNSL). Awareness amongst both clinicians and radiologists of the multifarious patterns of intra-cranial involvement in patients with HIV is, therefore, of utmost importance, as the treatment and prognosis of these entities are entirely different.

Keywords

ring-enhancing lesions; brain biopsy; CNS lymphoma; radiological findings

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