NEURORADIOLOGY


Case 38 :
A 55-year old HIV positive male presents with progressive difficulty in breathing. Tracheostomy was performed, and the patient is sent for a CT scan of the sinuses.
What is the diagnosis?
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Imaging Diagnosis

AID-RELATED LYMPHOMA

Discussion

Aggressive lymphomas, a general term that includes any cancer that infects the lymph system, can occur among patients who are HIV-positive. It is estimated that 10 percent of HIV-positive patients will develop lymphoma. The lymphomas that are most often seen in HIV patients who develop them are large cell immunoblastic; small non-cleaved cell (Burkitt's and Non-Burkitt's); primary central nervous system (CNS); and Hodgkin's disease.
Large cell immunoblastic lymphoma is an aggressive type of lymphoma that grows rapidly and may involve the brain, bone, skin or gastrointestinal tract. Small non-cleaved cell lymphoma (SNCL) is also an aggressive form that comes in three varieties, all of which are more prevalent in males. Burkitt's includes endemic (widespread) Burkitt's lymphoma; sporadic Burkitt's lymphoma; and non-Burkitt's lymphoma.
Primary central nervous system (CNS) lymphoma is lymphoma limited to the brain and brain stem without widespread disease. An increasing incidence of this disease has been seen among AIDS patients and other individuals with compromised immune systems. Hodgkin's disease or Hodgkin's lymphoma is a malignant (cancerous) growth of cells in the lymph system.
The symptoms, staging and methods of diagnosing Hodgkins's disease are the same for both the AIDS and non-AIDS related forms. Likewise, treatment may include radiation therapy, chemotherapy and bone marrow and blood stem cell transplants