101. AIDS-Related Central Nervous System Toxoplasmosis With Increased 18F-Fluoroethyl-L-Tyrosine Amino Acid PET Uptake Due to LAT1/2 Expression of Inflammatory Cells.
- Author
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Hutterer M, Bumes E, Riemenschneider MJ, Grosse J, Hellwig D, Galldiks N, Langen KJ, and Hau P
- Subjects
- Adult, Biological Transport, Brain Neoplasms diagnostic imaging, Diagnosis, Differential, Female, Humans, Inflammation pathology, Toxoplasmosis, Cerebral complications, Toxoplasmosis, Cerebral metabolism, Tyrosine metabolism, Acquired Immunodeficiency Syndrome complications, Adaptor Proteins, Signal Transducing metabolism, Gene Expression Regulation, Large Neutral Amino Acid-Transporter 1 metabolism, Positron-Emission Tomography, Toxoplasmosis, Cerebral diagnostic imaging, Tyrosine analogs & derivatives
- Abstract
We report the case of a 40-year-old woman with a progressive right-sided hemiparesis. Standard MRI revealed a contrast-enhancing brain lesion within the left basal ganglia. Ffluoroethyl-L-tyrosine (F-FET) PET showed a distinct tracer uptake (lesion-to-brain ratio [LBR]: LBRmax = 2.03, LBRmean = 1.68) with a significant larger metabolic lesion volume than contrast-enhancement in MRI, indicating cerebral glioma. Surprisingly, histopathologic analysis demonstrated central nervous system toxoplasmosis with pronounced inflammatory reaction (reactive astrogliosis, microglia activation, macrophage, and T-lymphocyte infiltration), which was associated with strong LAT1/LAT2/CD98 expression. In conclusion, inflammatory brain lesions, such as cerebral toxoplasmosis, represent a potential pitfall of F-FET PET mimicking a brain tumor.
- Published
- 2017
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