Original article Magnetic resonance imaging, thallium-201 SPET scanning, and laboratory analyses for discrimination of cerebral lymphoma and toxoplasmosis in AIDS

(201 Tl) SPET scanning with laboratory analyses including CSF DNA detection, brain biopsy, and necropsy in the discrimination of cerebral lymphoma and toxoplasmosis in patients with AIDS. Methods: A retrospective study of 32 patients infected with HIV who had focal CNS lesions on MRI as a result of either lymphoma or toxoplasmosis. Results: 18 patients had lymphoma, 12 had toxoplasmosis, and two had both. Toxoplasma IgG antibodies were detected in only seven patients—four with toxoplasmosis, two with lymphoma, and one with both diagnoses. Epstein‐Barr virus DNA was detected in CSF of all six patients with lymphoma and none of two with toxoplasmosis.MRI showed multiple lesions in 23 patients, appearances did not discriminate between lymphoma and toxoplasmosis;nine patients had single lesions, of these eight had lymphoma (p=0.044, two tailed Fisher’s exact test) 201 Tl SPET showed accumulation in 17 with lymphoma and six with toxoplasmosis (p = 0.034, two tailed Fisher’s exact test). Of nine patients with single lesions on MRI and 201 Tl SPET with focal accumulation eight had lymphoma. 201