PCNSL in HIV infected patients

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PCNSL in HIV infected patients

What are the typical clinical features, diagnostic findings, and treatment for PCNSL in HIV-infected patients? 

Presenting features of PCNSL vary based on location but frequently include focal signs, cognitive and personality changes, or increased intracranial pressure.

What are the diagnostic findings of PCNSL in HIV infected patients

It commonly appears as a single enhancing lesion on CT or MRI. Seizures are rare due to typical involvement of subcortical structures.

It is overwhelmingly a diffuse, large B-cell lymphoma diagnosed by stereotactic biopsy, CSF cytology or cytometry, or vitrectomy if ocular involvement is noted. 

How is PCNSL in HIV infected patients treated?

Treatment involves induction with high-dose methotrexate in combination with a variety of other chemotherapy agents followed by consolidation with whole brain radiation and possibly other types of chemotherapies.

Additionally, ART must also be initiated.

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