Case 365

Case 365


Male patient, 42 years old, infected with HIV for 15 years, on regular antirretroviral therapy (ART), was referred to Tertiary Care to investigate bradypsychia, mental confusion, walking difficulty, overall weakness (especially on the right), nausea, vomiting, diarrhea and low right visual acuity, with one month of evolution. Presented an episode of seizure without fever. Lumbar puncture was performed (which revealed atypical B-cell infiltration) and brain magnetic resonance imaging (MRI) was requested.

Image 1: Brain magnetic resonance, axial view, FLAIR-weighted.


Image 2: Brain magnetic resonance of the brain, axial view, diffusion-weighted (DWI) - (A) and apparent diffusion coefficient (ADC) Map - (B).


Image 3: Brain magnetic resonance, sagittal view, T1-weighted, after the intravenous gadolinium-based contrast injection.

Considering the common disorders of the central nervous system (CNS) in patients with AIDS (Acquired Human Immunodeficiency Syndrome), what is the most likely diagnosis?

Questão de Prova

(State Health Department - Espírito Santo - Brazil)
Regarding primary central nervous system lymphoma, related to HIV infection, check the correct option: