Cytomegalovirus disease presenting as a focal brain mass: report of two cases.
OBJECTIVE
Although the differential diagnosis of intracranial lesions in patients who have tested positive for human immunodeficiency virus is extensive, toxoplasmosis, lymphoma, and progressive multifocal leukoencephalopathy comprise approximately 90% of such cases. Cytomegalovirus infection of the central nervous system may be difficult to diagnose and rarely presents as mass lesions revealed by radiographic studies.


METHODS
Two patients who had tested positive for human immunodeficiency virus presented with progressive focal neurological deficits. Radiographic studies revealed solitary contrast-enhancing lesions in the right basal ganglia and right cerebellar hemisphere, respectively.


METHODS
The first patient underwent a stereotactic biopsy but died despite appropriate therapy. The second patient died without tissue having been obtained for diagnosis. Postmortem examinations revealed necrotizing lesions with diffuse areas of infiltrating histiocytes containing eosinophilic cytomegalovirus inclusion bodies.


CONCLUSIONS
Although rare, cytomegalovirus infection should be considered in patients who have tested positive for human immunodeficiency virus and who present with enhancing intracranial lesions.
Huang
P P
PP
Department of Neurosurgery, New York University Medical Center, New York, USA.
McMeeking
A A
AA
Stempien
M J
MJ
Zagzag
D
D
D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000473:pathology; D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D001479:Basal Ganglia / Q000473:pathology; D001480:Basal Ganglia Diseases / Q000175:diagnosis* / Q000473:pathology; D002526:Cerebellar Diseases / Q000175:diagnosis* / Q000473:pathology; D002531:Cerebellum / Q000473:pathology; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed