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[Primary brain lymphoma in AIDS. 17 cases studied by MRI before stereotaxic biopsies]
Y S Cordoliani1, C Derosier, C Pharaboz
1Service d'imagerie médicale, Hôpital d'instruction des Armées du Val-de-Grâce, Paris.
Aim:
Determining which semiological criteria might help to suggest lymphoma when an intracerebral mass in observed in a patient with AIDS. The use of these criteria might shorten the duration of the anti-toxoplasmic test treatment and to perform puncture earlier. The fast growth of the lymphomas may account for the rapid death of these patients if untreated, but as a corollary, its increase in size can be objectively measured over a short period, about ten days. MEANS: Retrospective study of 17 lymphomas diagnosed with stereotaxic puncture.
Results:
The most discriminating criteria are ventricular encasement or an original site in the white matter, as well as the moderate character of the edema and of the mass effect relative to the volume of the tumor. Other arguments also help: simple lesion, large size, sinuous contour, no signs of hemorrhage.
Conclusion:
The diagnosis of lymphoma can often be proposed at once. A control must then be performed very soon, with stereotaxic puncture if the volume of the lesion has increased in the meantime.