Correlation between clinical apparatus-based differential diagnosis and neuropathological diagnosis in patients with AIDS

During the course of HIV infection, the majority of patients develop opportunistic cerebral neuro-manifestations. If conventional diagnostic tools are not sufficient, a stereotactic biopsy is often necessary. In order to evaluate the correctness of the clinical diagnosis of cerebral neuro-manifestat...

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Bibliographic Details
Published in:Nervenarzt 2004-08, Vol.75 (8), p.763-769
Main Authors: Akova-Oztürk, E, Evers, S, Colak-Ekici, R, Heese, C, Rickert, C H, Reichelt, D, Husstedt, I W
Format: Article
Language:ger
Subjects:
Acquired Immunodeficiency Syndrome - pathology
Adult
AIDS Dementia Complex - pathology
Biopsy
Brain - pathology
Brain Diseases - diagnosis
Brain Diseases - pathology
Brain Neoplasms - pathology
Cadaver
Diagnosis, Differential
Female
Humans
In Vitro Techniques
Leukoencephalopathy, Progressive Multifocal - pathology
Lymphoma - pathology
Male
Retrospective Studies
Sensitivity and Specificity
Statistics as Topic
Stereotaxic Techniques
Toxoplasmosis, Cerebral - pathology
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Summary:During the course of HIV infection, the majority of patients develop opportunistic cerebral neuro-manifestations. If conventional diagnostic tools are not sufficient, a stereotactic biopsy is often necessary. In order to evaluate the correctness of the clinical diagnosis of cerebral neuro-manifestations in HIV-infected patients, we compared the results of cerebral biopsy or autopsy with the previous clinical diagnosis. A total of 19 biopsies and 49 autopsies could be analyzed. Except for HIV-associated encephalopathy, we detected a very high conformity between the clinical and the neuropathological diagnoses. We obtained the best sensitivity for progressive multifocal leukoencephalopathy (PML), whereas for cerebral toxoplasmosis the worst sensitivity and specificity was identified. We conclude that the diagnosis of PML can be made on clinical grounds alone, whereas the diagnosis of cerebral toxoplasmosis and lymphoma often requires a biopsy, which should be performed early.
ISSN:0028-2804