Document Detail


Eccentric target sign in cerebral toxoplasmosis: neuropathological correlate to the imaging feature.
MedLine Citation:
PMID:  20512900     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cerebral toxoplasmosis remains one of the most common focal brain lesions in patients with acquired immune deficiency syndrome (AIDS). Diagnosis is a challenge because on cranial imaging it closely mimics central nervous system lymphoma, primary and metastatic central nervous system (CNS) tumors, or other intracranial infections like tuberculoma or abscesses. A magnetic resonance imaging (MRI) feature on postcontrast T1-weighted sequences considered pathognomonic of toxoplasmosis is the "eccentric target sign." The pathological correlate of this imaging sign has been speculative. Herein we correlate the underlying histopathology to the MR feature of eccentric target sign in a patient with autopsy-proven HIV/AIDS-related cerebral toxoplasmosis. The central enhancing core of the target seen on MRI was produced by a leash of inflamed vessels extending down the length of the sulcus that was surrounded by concentric zones of necrosis and a wall composed of histiocytes and proliferating blood vessels, with impaired permeability producing the peripheral enhancing rim.
Authors:
G G Sharath Kumar; A Mahadevan; A S Guruprasad; Jerry M E Kovoor; P Satishchandra; Avindra Nath; Udaykumar Ranga; S K Shankar
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of magnetic resonance imaging : JMRI     Volume:  31     ISSN:  1522-2586     ISO Abbreviation:  J Magn Reson Imaging     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-31     Completed Date:  2010-09-28     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  9105850     Medline TA:  J Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1469-72     Citation Subset:  IM    
Affiliation:
Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health & Neurosciences, Bangalore 560 029, India.
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / diagnosis*,  parasitology
Adult
Brain / pathology
Brain Diseases / parasitology,  pathology,  virology
Cell Proliferation
HIV Infections / complications*
Humans
Magnetic Resonance Imaging / methods
Male
Permeability
Sensitivity and Specificity
Tomography, X-Ray Computed / methods
Toxoplasmosis, Cerebral / diagnosis,  pathology*
Grant Support
ID/Acronym/Agency:
1R01NS055628-01A2/NS/NINDS NIH HHS; R01 NS055628-01A2/NS/NINDS NIH HHS
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