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免疫功能低下患者脑弓形虫病与原发性中枢神经系统淋巴瘤的复杂鉴别诊断:脑活检的价值

Complex Differential Diagnosis Between Cerebral Toxoplasmosis and Primary CNS Lymphoma in Immunocompromised Patients: The Value of Brain Biopsy.

作者信息

Landart Matthieu, Mathon Bertrand

机构信息

Sorbonne University, Department of Neurosurgery, AP-HP, La Pitié-Salpêtrière Hospital, Paris, France.

出版信息

Turk Neurosurg. 2025;35(3):518-522. doi: 10.5137/1019-5149.JTN.44943-23.2.

Abstract

We report the case of a 24-year-old woman who received immunosuppressive treatment for systemic lupus erythematosus. In her past medical history, she had been treated for disseminated toxoplasmosis (ocular and cardiac). Four months later, she was hospitalized and treated for a presentation suggestive of cerebral toxoplasmosis. The diagnosis of primary central nervous system lymphoma (PCNSL) was finally made using stereotactic brain biopsy; however, the evolution was rapidly fatal within 6 days after admission. We discuss the challenge of differential diagnosis between cerebral toxoplasmosis and PCNSL in immunocompromised patients and the role of brain biopsy in patient management.

摘要

我们报告了一例24岁女性系统性红斑狼疮患者接受免疫抑制治疗的病例。她既往有播散性弓形虫病(眼部和心脏)治疗史。四个月后,她因疑似脑弓形虫病住院治疗。最终通过立体定向脑活检确诊为原发性中枢神经系统淋巴瘤(PCNSL);然而,入院后6天内病情迅速恶化并导致死亡。我们讨论了免疫功能低下患者脑弓形虫病与PCNSL鉴别诊断的挑战以及脑活检在患者管理中的作用。

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