Ver el código de «Primary CNS lymphoma»

==Background==
*[[AIDS]]-defining malignancy that is strongly related to [[Epstein-Barr virus]] (EBV) infection
*Occurs with profound immunosuppression (CD4 counts <50cells/uL)
*Accounts for approximately 20 to 30% of CNS lesions in patients with AIDs
==Clinical Features==
*Can present with a variety of [[focal neuro deficits|focal]] or nonfocal signs and symptoms
*[[Confusion]], [[lethargy]], memory loss, [[weakness|hemiparesis]], aphasia, [[AMS|mental status changes]],  [[seizures]]
*Constitutional symptoms (systemic B symptoms) e.g. [[fever]]

==Differential Diagnosis==
{{HIV associated conditions}}

==Evaluation==
*[[head CT|CT]] scan: well-defined focal lesion, isodense or hyperdense to the gray matter
*[[brain MRI|MRI]] (higher diagnostic yield): variable, isointense or hypointense lesions on T1-weighted images
**Lesions that involve the corpus callosum, periventricular, or periependymal areas are more likely to be due to a lymphoma<ref>Forsyth PA. Biology and management of AIDS-associated primary CNS lymphomas. Hematol Oncol Clin North Am. 1996;10(5):1125-34.</ref>
**Solitary lesions are often large (>4cm)<ref>Thurnher MM. CNS involvement in AIDS: spectrum of CT and MR findings. Eur Radiol. 1997;7(7):1091-7.</ref>
*[[Lumbar puncture]]: 
**CSF cytology
**CSF EBV PCR
**Should also obtain [[toxoplasma]] serologies, most are treated empirically for toxoplasma while serology is pending
*Stereotactic brain biopsy if necessary

==Management==
*High-dose [[methotrexate]] therapy (3 g/m<sup>2</sup> for four to eight cycles) 
*[[Steroids]] 
*Potent antiretroviral therapy 
*Radiation therapy

==Disposition==

==See Also==
*[[HIV - AIDS (main)]]
*[[HIV neurologic complications]]

==External Links==

==References==
<references/>

[[Category:ID]]
[[Category:Neurology]]