Dentate nuclei involvement in AIDS patients with CNS cryptococcosis: Imaging findings with pathologic correlation

Armando Ruiz, M. Judith Post, Claudia Cunha Bundschu

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Purpose: Our goal was to describe the involvement of the dentate nuclei in AIDS patients with CNS cryptococcosis since this finding has not been emphasized in previous radiological literature. Method: Plain and contrast- enhanced CT of the brain (10 and 10) MR studies (1 premortem and 1 postmortem), and autopsy findings in 11 AIDS patients with CNS cryptococcosis were reviewed. The imaging studies and pathological specimens were analyzed for signs of meningitis, presence of dilated Virchow-Robin spaces, gelatinous pseudocysts, cryptococcoma, ventriculomegaly, choroid plexus, and ependymal lesions. Results: Five of 11 patients were found at autopsy to have macroscopically visible 'cystic' lesions in the dentate nuclei that were not detected on CT (10 patients), but were seen on premortem MR (1 patient). Macroscopic supratentorial (basal ganglia, thalamic, midbrain) lesions were detected by CT in 5 of 11 patients and by MR in 2 of 2 patients. Enhancement of the leptomeninges was seen in only 1 patient by CT despite pathological evidence of cryptococcal meningitis in all 11 patients. Dilated Virchow- Robin spaces were seen in all 11 pathologic specimens and in the 2 MR studies but not on CT. Communicating hydrocephalus was detected by CT in two patients. Conclusion: CT scans of the brain underestimate infratentorial parenchymal cryptococcal disease. MR is a more sensitive procedure to evaluate cerebellar and brainstem cryptococcosis, including the dentate nuclei, which in our autopsy series was not an uncommon site to be infected with cryptococcal gelatinous pseudocysts.

Original languageEnglish
Pages (from-to)175-182
Number of pages8
JournalJournal of Computer Assisted Tomography
Volume21
Issue number2
DOIs
StatePublished - Mar 26 1997

Fingerprint

Cerebellar Nuclei
Cryptococcosis
Acquired Immunodeficiency Syndrome
Autopsy
Songbirds
Cryptococcal Meningitis
Choroid Plexus
Brain
Hydrocephalus
Mesencephalon
Basal Ganglia
Meningitis
Brain Stem

Keywords

  • Acquired immune deficiency syndrome (AIDS
  • Brain, infection
  • Computed tomography
  • Cryptococcosis
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Dentate nuclei involvement in AIDS patients with CNS cryptococcosis : Imaging findings with pathologic correlation. / Ruiz, Armando; Judith Post, M.; Cunha Bundschu, Claudia.

In: Journal of Computer Assisted Tomography, Vol. 21, No. 2, 26.03.1997, p. 175-182.

Research output: Contribution to journalArticle

Ruiz, Armando ; Judith Post, M. ; Cunha Bundschu, Claudia. / Dentate nuclei involvement in AIDS patients with CNS cryptococcosis : Imaging findings with pathologic correlation. In: Journal of Computer Assisted Tomography. 1997 ; Vol. 21, No. 2. pp. 175-182.
@article{81b7db43c5f34229ba782d583884caee,
title = "Dentate nuclei involvement in AIDS patients with CNS cryptococcosis: Imaging findings with pathologic correlation",
abstract = "Purpose: Our goal was to describe the involvement of the dentate nuclei in AIDS patients with CNS cryptococcosis since this finding has not been emphasized in previous radiological literature. Method: Plain and contrast- enhanced CT of the brain (10 and 10) MR studies (1 premortem and 1 postmortem), and autopsy findings in 11 AIDS patients with CNS cryptococcosis were reviewed. The imaging studies and pathological specimens were analyzed for signs of meningitis, presence of dilated Virchow-Robin spaces, gelatinous pseudocysts, cryptococcoma, ventriculomegaly, choroid plexus, and ependymal lesions. Results: Five of 11 patients were found at autopsy to have macroscopically visible 'cystic' lesions in the dentate nuclei that were not detected on CT (10 patients), but were seen on premortem MR (1 patient). Macroscopic supratentorial (basal ganglia, thalamic, midbrain) lesions were detected by CT in 5 of 11 patients and by MR in 2 of 2 patients. Enhancement of the leptomeninges was seen in only 1 patient by CT despite pathological evidence of cryptococcal meningitis in all 11 patients. Dilated Virchow- Robin spaces were seen in all 11 pathologic specimens and in the 2 MR studies but not on CT. Communicating hydrocephalus was detected by CT in two patients. Conclusion: CT scans of the brain underestimate infratentorial parenchymal cryptococcal disease. MR is a more sensitive procedure to evaluate cerebellar and brainstem cryptococcosis, including the dentate nuclei, which in our autopsy series was not an uncommon site to be infected with cryptococcal gelatinous pseudocysts.",
keywords = "Acquired immune deficiency syndrome (AIDS, Brain, infection, Computed tomography, Cryptococcosis, Magnetic resonance imaging",
author = "Armando Ruiz and {Judith Post}, M. and {Cunha Bundschu}, Claudia",
year = "1997",
month = "3",
day = "26",
doi = "10.1097/00004728-199703000-00003",
language = "English",
volume = "21",
pages = "175--182",
journal = "Journal of Computer Assisted Tomography",
issn = "0363-8715",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Dentate nuclei involvement in AIDS patients with CNS cryptococcosis

T2 - Imaging findings with pathologic correlation

AU - Ruiz, Armando

AU - Judith Post, M.

AU - Cunha Bundschu, Claudia

PY - 1997/3/26

Y1 - 1997/3/26

N2 - Purpose: Our goal was to describe the involvement of the dentate nuclei in AIDS patients with CNS cryptococcosis since this finding has not been emphasized in previous radiological literature. Method: Plain and contrast- enhanced CT of the brain (10 and 10) MR studies (1 premortem and 1 postmortem), and autopsy findings in 11 AIDS patients with CNS cryptococcosis were reviewed. The imaging studies and pathological specimens were analyzed for signs of meningitis, presence of dilated Virchow-Robin spaces, gelatinous pseudocysts, cryptococcoma, ventriculomegaly, choroid plexus, and ependymal lesions. Results: Five of 11 patients were found at autopsy to have macroscopically visible 'cystic' lesions in the dentate nuclei that were not detected on CT (10 patients), but were seen on premortem MR (1 patient). Macroscopic supratentorial (basal ganglia, thalamic, midbrain) lesions were detected by CT in 5 of 11 patients and by MR in 2 of 2 patients. Enhancement of the leptomeninges was seen in only 1 patient by CT despite pathological evidence of cryptococcal meningitis in all 11 patients. Dilated Virchow- Robin spaces were seen in all 11 pathologic specimens and in the 2 MR studies but not on CT. Communicating hydrocephalus was detected by CT in two patients. Conclusion: CT scans of the brain underestimate infratentorial parenchymal cryptococcal disease. MR is a more sensitive procedure to evaluate cerebellar and brainstem cryptococcosis, including the dentate nuclei, which in our autopsy series was not an uncommon site to be infected with cryptococcal gelatinous pseudocysts.

AB - Purpose: Our goal was to describe the involvement of the dentate nuclei in AIDS patients with CNS cryptococcosis since this finding has not been emphasized in previous radiological literature. Method: Plain and contrast- enhanced CT of the brain (10 and 10) MR studies (1 premortem and 1 postmortem), and autopsy findings in 11 AIDS patients with CNS cryptococcosis were reviewed. The imaging studies and pathological specimens were analyzed for signs of meningitis, presence of dilated Virchow-Robin spaces, gelatinous pseudocysts, cryptococcoma, ventriculomegaly, choroid plexus, and ependymal lesions. Results: Five of 11 patients were found at autopsy to have macroscopically visible 'cystic' lesions in the dentate nuclei that were not detected on CT (10 patients), but were seen on premortem MR (1 patient). Macroscopic supratentorial (basal ganglia, thalamic, midbrain) lesions were detected by CT in 5 of 11 patients and by MR in 2 of 2 patients. Enhancement of the leptomeninges was seen in only 1 patient by CT despite pathological evidence of cryptococcal meningitis in all 11 patients. Dilated Virchow- Robin spaces were seen in all 11 pathologic specimens and in the 2 MR studies but not on CT. Communicating hydrocephalus was detected by CT in two patients. Conclusion: CT scans of the brain underestimate infratentorial parenchymal cryptococcal disease. MR is a more sensitive procedure to evaluate cerebellar and brainstem cryptococcosis, including the dentate nuclei, which in our autopsy series was not an uncommon site to be infected with cryptococcal gelatinous pseudocysts.

KW - Acquired immune deficiency syndrome (AIDS

KW - Brain, infection

KW - Computed tomography

KW - Cryptococcosis

KW - Magnetic resonance imaging

UR - http://www.scopus.com/inward/record.url?scp=0342618591&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0342618591&partnerID=8YFLogxK

U2 - 10.1097/00004728-199703000-00003

DO - 10.1097/00004728-199703000-00003

M3 - Article

C2 - 9071282

AN - SCOPUS:0342618591

VL - 21

SP - 175

EP - 182

JO - Journal of Computer Assisted Tomography

JF - Journal of Computer Assisted Tomography

SN - 0363-8715

IS - 2

ER -