Multiple brain lesions with central calcification: can you hit the target?

Tremolizzo, Lucio; Galbussera, Alessia Antonella; Frigo, M.; Apale, Paolo; Fumagalli, Caterina; Appollonio, Ildebrando; Ferrarese, Carlo

doi:10.1007/s10072-007-0838-5

Cited by 2 publications

(2 citation statements)

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“…In particular, some authors do not consider the presence of a central calcification an essential feature to define a lesion as a target lesion. Such discrepancy, which represents a major interpretation problem 2,3 , depends on the description of target lesions through different neuroimaging techniques (CT versus MR) and in different diseases. Therefore, the expressions "target-like" or "ring-shaped" lesion have been proposed to describe lesions with peripheral enhancement but lacking the central calcification, whereas the term "target" should be reserved for cases where the central calcification is present.…”

Section: Discussionmentioning

confidence: 99%

Brain Targets: Can you Believe Your Own Eyes?

et al. 2014

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SUMMARY - Case ReportsCase AA 48-year-old woman of Peruvian origin presented for subacute onset of weakness in her left limbs. Neurologic examination showed moderate left hemiparesis with ipsilateral Babinski sign and deep tendon hyperreflexia. Head non-contrast enhanced CT scan demonstrated a hypodense lesion in the right diencephalic region. Brain MR scan with gadolinium ( Figure 1A) confirmed the presence of a cystic cavity with mild surrounding oedema and no contrast enhancement. The patient's conditions rapidly worsened; left hemiplegia developed and mental status progressively deteriorated. A second brain MR scan showed a further growth of the lesion. A contrast-enhanced chest and abdomen CT demonstrated multiple cavitary nodular lesions in the right lung with ipsilateral hilar and mediastinal lymphadenopathy. Bronchoscopy was performed; cytological and histological material was retrieved through bronchoalveolar lavage (BAL) and CT-guided lymph node biopsy. Histological examination showed granulomatous inflammation with multinucleated cells and areas of caseous necrosis. Cultural examination on BAL resulted positive for Mycobacterium tuberculosis. Diagnosis: Cerebral tuberculoma. Case BA 32-year-old man of Albanian origin presented with a four-month history of subcontinuous occipital headache, unresponsive to analgesics. Medical history, general and neurologic examinations were unremarkable. Head contrast-enhanced CT scan revealed a hyperdense right parafalcial posterior lesion, with peripheral ring contrast enhancement. Brain MR scan with gadolinium ( Figure 1B) showed two additional small lesions within the right hemisphere, both with ring gadolinium enhancement. Blood tests for HIV, Toxoplasma, Entamoeba and Echinococcus were negative, whereas ELISA assay on plasma resulted

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Section: Discussionmentioning

confidence: 99%

Brain Targets: Can you Believe Your Own Eyes?

et al. 2014

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“…Diagnosis of NCC is based on neuroimaging findings (brain CT and MRI), followed by serological assessment of specific anti-cysticercal antibodies. The identification of the scolex of the tapeworm on neuroimaging or also during fundoscopic examination is rare, but represents the only pathognomonic sign of NCC; highly suggestive imaging refers to contrast-enhanced ring lesions, eventually with a central calcification (target lesions) [6]. EITB assay is the most accurate laboratory test for detecting a serological evidence of the infection.…”

Section: Answersmentioning

confidence: 99%