Related Experiment Video
Updated: Feb 8, 2026
06:55
Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging
Published on: May 11, 2014
12.4K
Multicentric Cryptococcomas Mimicking Neoplasia in Immunocompetent Patient
Adrian Kelly1, Phila Mpanza1, Patrick Lekgwara1
1Department of Neurosurgery, Dr. George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
World Neurosurgery
|July 9, 2018
Summary
Central nervous system cryptococcomas are rare fungal mass lesions. Diagnosing this tumoral form in immunocompetent patients poses a challenge, often mimicking brain tumors.
Area of Science:
- Neurology
- Mycology
- Neurosurgery
Background:
- Fungal central nervous system (CNS) mass lesions are rare, with cryptococcomas being the most frequent.
- Cryptococcomas typically present as small lesions (3-10 mm) in the basal ganglia, often arising from basal meningitis.
- Rarely, chronic granulomatous processes can lead to tumoral-appearing CNS mass lesions.
Observation:
- A 19-year-old, immunocompetent male presented with progressive headaches and right upper limb monoplegia.
- Despite preoperative steroid treatment, the patient experienced worsening neurological deficits.
- Emergency resection revealed two lobar mass lesions confirmed as cryptococcosis involving gliotic brain parenchyma.
Findings:
- Histopathology confirmed extensive cryptococcosis in the resected brain parenchyma.
- The patient was human immunodeficiency virus negative with a high CD4 count, indicating immunocompetence.
Implications:
- Diagnosing tumoral cryptococcosis in immunocompetent individuals is challenging, often initially suspected as primary or secondary brain tumors.
- Comprehensive preoperative evaluations, including cerebrospinal fluid analysis and advanced magnetic resonance imaging, are crucial for considering cryptococcosis before histopathological confirmation.
Related Concept Videos
01:22Development of Immunocompetence
927
The initiation of cell-mediated immunity can be observed as early as the third month of fetal growth, with active antibody-mediated immunity following approximately one month later.
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
927
01:13Patient-centered Care
3.1K
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
3.1K
01:15Drug Dosing: Geriatric Patients
278
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
278
01:21Drug Dosing: Obese Patients
269
In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
269
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
239
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
239
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
266
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
266