Assuntos
Neoplasias da Mama/complicações , Cuidados Paliativos , Compressão da Medula Espinal/radioterapia , Neoplasias da Coluna Vertebral/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor nas Costas/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Cervicalgia/etiologia , Radiografia , Estudos Retrospectivos , Compressão da Medula Espinal/diagnóstico por imagem , Compressão da Medula Espinal/etiologia , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/secundário , Taxa de Sobrevida , Tempo para o TratamentoRESUMO
We describe the case of a 62-year-old man, who presented with a new onset of focal seizures of his right leg. There were no other clinical symptoms, and laboratory results were normal. Brain magnetic resonance imaging revealed multiple lesions, two supratentorial lesions were ring-enhancing. The brain biopsy tissue showed Histoplasma capsulatum abscesses. He improved on treatment with Amphotericin B. This case is reported since cerebral ring-enhancing lesions are rarely associated with histoplasmosis, which is also rare in an immunocompetent individual. We review the literature and discuss the radiologic and pathologic findings of this case compared with previous reports.
Assuntos
Abscesso Encefálico/imunologia , Abscesso Encefálico/patologia , Encefalite/complicações , Encefalite/imunologia , Histoplasmose/imunologia , Histoplasmose/patologia , Imunocompetência/imunologia , Encéfalo/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-IdadeRESUMO
The imaging modality used to diagnose and monitor brain gliomas is magnetic resonance imaging (MRI), with standard protocols including contrast-enhanced T1-weighted and fluid-attenuated inversion recovery (FLAIR) image sequences. Many clinical trials are currently using contrast-enhanced T1-weighted MR image sequences to evaluate tumor response to treatment, but it is our hypothesis that FLAIR sequences will detect higher tumor volumes and, therefore, should be the preferred image sequence for this purpose. In this retrospective study, a volumetric analysis was conducted on the post-contrast T1-weighted and FLAIR MR image sequences of 38 patients with confirmed brain gliomas. The two volumes were subsequently found to have a statistically significant positive correlation. The FLAIR volume was also found to be greater than the post-contrast T1-weighted volume in all 38 patients. As a result, FLAIR image sequences provide a more complete characterization of gliomas and may be more beneficial when observing tumor response after treatment.
