In cerebral toxoplasmosis, ring enhancement is very common, lesions tend to be smaller, and multiple lesions are seen. Antibodies against toxoplasmosis may also be very useful, since the vast majority of cerebral toxoplasmosis occur as a consequence of reactivity of a previous infection. Primary CNS lymphoma is often identified as a terminal manifestation of AIDS or on postmortem examination. Radiation therapy alone has usually been used in this group of patients. With doses in the 3500 to 4000 cGy range, median duration of survival has been only 72 to 119 days.
Most patients respond to treatment by showing partial improvement in neurologic symptoms.
Autopsies have revealed that these patients die of opportunistic infections as well as tumor progression. Treatment of these patients is also complicated by other AIDS-related CNS infections, including subacute AIDS encephalitis, cytomegalovirus encephalitis, and toxoplasmosis encephalitis. Ziegler JL, Beckstead JA, Volberding PA, et al. MacMahon EM, Glass JD, Hayward SD, et al. Goldstein JD, Dickson DW, Moser FG, et al.