@bensha answer the question Tx the pt - goodman

[ArchivalUser]

Step 1 associations. @bensha This question is from robin's

A 20-year-old, HIV-positive man has had a decreased level of consciousness for the past week. He now experiences a seizure. On physical examination, his temperature is 37.6°C. MRI of the brain shows several 1- to 3-cm, ring-enhancing lesions in the cerebral gray matter bilaterally. A stereotaxic biopsy is performed. What pathologic finding is most likely to be present on microscopic examination of the biopsy specimen?
A. Large atypical lymphocytes B. Budding cells with pseudohyphae C. Spongiform encephalopathy
D. Toxoplasma pseudocysts E. Metastatic squamous cell carcinoma

[ArchivalUser]

What is the treatment?

What malignancy can this pt show also?

[ArchivalUser]

Yes, he might have Tox pseudocysts as he has multiple ring enhancing lesions. Also primary CNS lymphoma can occur with HIV positive patients due to EBV. Though the CNS lymphoma might be solitary and one way to distinguish bet the 2. If Pyremethamine+ Sulfdiazine doesnt clear the lesion after 2 weeks of therapy then CNS lymphoma.

[ArchivalUser]

Very good


B-Cell Lymphoma
We must suspect of this in any HIV Pt that is suspected to have Toxoplasmosis w/o responding to the Tx.
and Toxoplasmosis are well defined intracraneal mass (Ring-enhancing lesion in MRI).


Cerebral Toxoplasmosis
In AIDS Patient you can Tx w/ SULFADIZINE + PYRIMETHAMINE. Should be give as a lifelong suppressive therapy.