Turkish Neurosurgery
2025 , Vol 35 , Num 3
Complex Differential Diagnosis Between Cerebral Toxoplasmosis and Primary CNS Lymphoma in Immunocompromised Patients: The Value of Brain Biopsy
1Sorbonne University, Department of Neurosurgery, AP-HP, La Pitié-Salpêtrière Hospital, Paris, France2Paris Brain Institute, ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne University, UMRS 1127, Paris, France
3Sorbonne University, GRC 23, Brain Machine Interface, APHP, La Pitié-Salpêtrière Hospital, Paris, France
4Sorbonne University, GRC 33, Robotics and Surgical Innovation, APHP, Paris, France DOI : 10.5137/1019-5149.JTN.44943-23.2 We report the case of a 24-year-old woman who received immunosuppressive treatment for systemic lupus erythematosus. In her past medical history, she had been treated for disseminated toxoplasmosis (ocular and cardiac). Four months later, she was hospitalized and treated for a presentation suggestive of cerebral toxoplasmosis. The diagnosis of primary central nervous system lymphoma (PCNSL) was finally made using stereotactic brain biopsy; however, the evolution was rapidly fatal within 6 days after admission. We discuss the challenge of differential diagnosis between cerebral toxoplasmosis and PCNSL in immunocompromised patients and the role of brain biopsy in patient management. Keywords : Cerebral toxoplasmosis, Primary CNS lymphoma, Immunosuppression, Brain biopsy, Radiological characteristics