Dados do Trabalho

Título

Central Nervous System Lymphoma in a immunocompromised patient, a case report.

Descrição sucinta do(s) objetivo(s)

The aim of this presentation is to highlight radiologic findings of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in Central Nervous System (CNS) Lymphoma in an immunocompromised patient.

História clínica

The case involves a 43-year-old patient with no significant medical history, presenting to the emergency room due to emotional disturbances, apathy, disorientation, and prolonged periods of sleep for approximately one month. Laboratory results, showing pancytopenia and a positive HIV test, prompted Contrast-Enhanced CT and MRI with spectroscopy. Multifocal nodular lesions were observed, initially suggestive of Primary CNS Lymphoma versus Toxoplasmosis, later confirmed as lymphoma through stereotactic biopsy.

Discussão e diagnóstico

CNS lymphoma exclusively affects the brain, leptomeninges, spinal cord, or eyes, representing a rare, aggressive tumor with a poor prognosis, especially in immunocompromised patients. Diagnosis relies on CT and MRI findings, revealing typical features such as multifocal heterogeneous lesions, hypointensity in T2 and Flair sequences with diffusion restriction, and contrast enhancement. Spectroscopy supported the diagnosis, demonstrating increased choline peaks and marked reduction in N-acetylaspartate.

Conclusões

The significance of imaging in diagnosing CNS Lymphoma in immunocompromised patients is emphasized, given the complexity of this tumor and its resemblance to other differential diagnoses, particularly infectious ones. Findings, including nodular lesions and characteristic patterns in spectroscopy, proved crucial for diagnosis, underscoring the importance of these tools in the early detection and clinical management of neurological diseases in immunocompromised contexts.

Palavras Chave

HIV; Tumores do SNC; Linfoma

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