CNS Ring-Enhancing Lesions - Immunocompromised vs Immunocompetent
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CNS Ring-Enhancing Lesions - Immunocompromised vs Immunocompetent

Multiple Ring-Enhancing Lesions:

 • Toxoplasmosis (CD4 < 100)

 • Other manifestations- Pneumonitis, Chorioretinitis

 • Diagnosis- Compatible syndrome + MRI lesions + toxo IgG

 • CNS PCR 50% sensitive

Lymphomatoid granulomatosis:

 • EBV-associated lymphoproliferative disease

 • 30% present w/ CNS lesions

 • 80% with lung nodules, may also see skin lesions, LAD, and hepatomegaly/splenomegaly

Other infections including: M, avium, TB, histoplasmosis, cryptococcus, and aspergillus

Solitary Lesion:

 • CNS Lymphoma (CD4 <100), 25% with multiple lesions

Infectious:

 • Bacterial

 • Tuberculosis

 • Syphilis

 • Pyogenic Abscess

 • Nocardia

 • Parasitic

 • Neurocysticercosis

Malignancy:

 • Glioblastoma

 • Metastatic disease

Inflammatory:

 • Multiple Sclerosis and other demyelinating diseases (often form an incomplete ring)

 • Sarcoidosis

 • Neuro Behcets

Vascular lesions



Dr. Ann Marie Kumfer @AnnKumfer



#CNS #RingEnhancing #Lesions #Brain #differential #diagnosis #causes #radiology #neurology
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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