A 39 year old man who has been HIV positive for at least 8 years has - ProProfs
Topics-
Products +
     

A 39-year-old man who has been HIV-positive for at least 8 years has received no antiretroviral therapy. He has had left-sided weakness for the past month. He sees the physician 1 day after experiencing a generalized seizure. On physical examination, he is afebrile. There is 4/5 motor strength in the left upper extremity. CT scan of the head shows no intracranial hemorrhage, but there is a midline shift. MRI of the brain shows a 4-cm mass in the region of the putamen near the right internal capsule, a 3-cm mass in the right centrum semiovale, and a 1-cm mass near the splenium of the corpus callosum. These masses are circumscribed and solid. CSF from a lumbar punCTure shows an elevated protein concentration and a normal glucose level. Cytologic examination shows large cells with large nuclei and scant cytoplasm that mark with CD19, but not with GFAP or cytokeratin. What is the most likely diagnosis?



A. Cytomegalovirus encephalitis
B. Glioblastoma multiforme
C. Kaposi sarcoma
D. Large B-cell lymphoma
E. Progressive multifocal leukoencephalopathy
F. Toxoplasmosis
Asked by D.Barlet on Sep 09, 2016

This question is part of

Pathology Review ch 28 CNS prt 3

+ AnswerRequest Answer
...

1 Answer

John Smith

John Smith

Answered on Sep 09, 2016

Large b-cell lymphoma-(d) non-hodgkin lymphomas, including large b-cell lymphomas, are uncommon in the brain, but they may be seen in immunocompromised patients, particularly patients with aids. they tend to be multifocal. cytomegalovirus infection is common in aids, but it is unlikely to produce mass lesions. a glioblastoma multiforme can be a large infiltrative and destructive mass, but the cells are typically gfap positive and cd19 negative. kaposi sarcoma can occur in association with hiv infection, but cns involvement is rare, and the cells are cd34 positive. progressive multifocal leukoencephalopathy produces granular white matter lesions with large, bizarre oligodendrocytes infected with jc papovavirus. toxoplasmosis can produce multiple mass lesions, but they are chronic abscesses that are filled with necrotic material and surrounded by gliosis; toxoplasma pseudocysts may be found in the abscesses. bp7 835bp8 885pbd7 1408pbd8 1337
 Reply

Search for Google images
Select a recommended image
Upload from your computer
Search for Google images
Select a recommended image
Upload from your computer
Search for Google images
Select a recommended image
Upload from your computer

Email Sent
We have sent an email to your address "" with instructions to reset your password.