Brain abscess differential diagnosis: Difference between revisions
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{{Brain abscess}} | {{Brain abscess}} | ||
==Overview== | ==Overview== | ||
Brain abscess must be differentiated from [[metastatic tumor]]s, necrotic tumors, and [[lymphoma]]s.<ref name="pmid10472982">{{cite journal| author=Desprechins B, Stadnik T, Koerts G, Shabana W, Breucq C, Osteaux M| title=Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses. | journal=AJNR Am J Neuroradiol | year= 1999 | volume= 20 | issue= 7 | pages= 1252-7 | pmid=10472982 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10472982 }} </ref><ref name="pmid7863938">{{cite journal| author=Ruiz A, Ganz WI, Post MJ, Camp A, Landy H, Mallin W et al.| title=Use of thallium-201 brain SPECT to differentiate cerebral lymphoma from toxoplasma encephalitis in AIDS patients. | journal=AJNR Am J Neuroradiol | year= 1994 | volume= 15 | issue= 10 | pages= 1885-94 | pmid=7863938 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7863938}} </ref> | Brain abscess must be differentiated from [[metastatic tumor]]s, [[necrotic]] tumors, and [[lymphoma]]s.<ref name="pmid10472982">{{cite journal| author=Desprechins B, Stadnik T, Koerts G, Shabana W, Breucq C, Osteaux M| title=Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses. | journal=AJNR Am J Neuroradiol | year= 1999 | volume= 20 | issue= 7 | pages= 1252-7 | pmid=10472982 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10472982 }} </ref><ref name="pmid7863938">{{cite journal| author=Ruiz A, Ganz WI, Post MJ, Camp A, Landy H, Mallin W et al.| title=Use of thallium-201 brain SPECT to differentiate cerebral lymphoma from toxoplasma encephalitis in AIDS patients. | journal=AJNR Am J Neuroradiol | year= 1994 | volume= 15 | issue= 10 | pages= 1885-94 | pmid=7863938 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7863938}} </ref> | ||
== Differential Diagnosis== | == Differential Diagnosis== | ||
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*Necrotic tumors | *Necrotic tumors | ||
*[[Lymphoma]]s | *[[Lymphoma]]s | ||
===Metastatic Tumor=== | ===Metastatic Tumor=== | ||
| Line 24: | Line 22: | ||
*Some studies suggest that indium scans can help differentiate abscess from CA, and [[thallium]] [[SPECT]] scans can distinguish [[CNS]] toxoplasmosis from [[lymphoma]].<ref name="pmid7863938">{{cite journal| author=Ruiz A, Ganz WI, Post MJ, Camp A, Landy H, Mallin W et al.| title=Use of thallium-201 brain SPECT to differentiate cerebral lymphoma from toxoplasma encephalitis in AIDS patients. | journal=AJNR Am J Neuroradiol | year= 1994 | volume= 15 | issue= 10 | pages= 1885-94 | pmid=7863938 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7863938}} </ref> | *Some studies suggest that indium scans can help differentiate abscess from CA, and [[thallium]] [[SPECT]] scans can distinguish [[CNS]] toxoplasmosis from [[lymphoma]].<ref name="pmid7863938">{{cite journal| author=Ruiz A, Ganz WI, Post MJ, Camp A, Landy H, Mallin W et al.| title=Use of thallium-201 brain SPECT to differentiate cerebral lymphoma from toxoplasma encephalitis in AIDS patients. | journal=AJNR Am J Neuroradiol | year= 1994 | volume= 15 | issue= 10 | pages= 1885-94 | pmid=7863938 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7863938}} </ref> | ||
Despite these differences, the true diagnosis is sometimes not made until [[biopsy]]. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 18:20, 30 October 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Brain abscess must be differentiated from metastatic tumors, necrotic tumors, and lymphomas.[1][2]
Differential Diagnosis
Brain abscess must be differentiated from:
- Metastatic tumors
- Necrotic tumors
- Lymphomas
Metastatic Tumor
- The big differential is that the abscess is often located in watershed regions, and tumors often enhance diffusely with contrast.
Necrotic Tumor
- Diagnosis of brain abscesses and necrotic tumors is often impossible without conventional MR imaging.[1]
- Several studies demonstrate the utility of Diffusion-weighted imaging (DWI) to differentiate between necrotic or cystic lesions and brain abscesses.[3]
- DWI has a sensitivity and specificity of over 90% for distinguishing abscess (low ADC) from necrotic tumors (high ADC).
Lymphoma
- Some studies suggest that indium scans can help differentiate abscess from CA, and thallium SPECT scans can distinguish CNS toxoplasmosis from lymphoma.[2]
Despite these differences, the true diagnosis is sometimes not made until biopsy.
References
- ↑ 1.0 1.1 Desprechins B, Stadnik T, Koerts G, Shabana W, Breucq C, Osteaux M (1999). "Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses". AJNR Am J Neuroradiol. 20 (7): 1252–7. PMID 10472982.
- ↑ 2.0 2.1 Ruiz A, Ganz WI, Post MJ, Camp A, Landy H, Mallin W; et al. (1994). "Use of thallium-201 brain SPECT to differentiate cerebral lymphoma from toxoplasma encephalitis in AIDS patients". AJNR Am J Neuroradiol. 15 (10): 1885–94. PMID 7863938.
- ↑ Bavelloni A, Piazzi M, Raffini M, Faenza I, Blalock WL (2015). "Prohibitin 2: At a communications crossroads". IUBMB Life. 67 (4): 239–54. doi:10.1002/iub.1366. PMID 25904163.