AIDS-Related Central Nervous System Toxoplasmosis With Increased 18F-Fluoroethyl-L-Tyrosine Amino Acid PET Uptake Due to LAT1/2 Expression of Inflammatory Cells

Clinical Nuclear Medicine
Markus HuttererPeter Hau

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.

References

Nov 28, 2006·Nuclear Medicine and Biology·Dagmar SalberKarl-Josef Langen
Nov 17, 2007·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Dagmar SalberKarl-Josef Langen
Apr 17, 2010·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Dagmar SalberKarl-Josef Langen
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Jul 30, 2016·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Markus HuttererEugen Trinka
Oct 28, 2016·Nature Reviews. Neurology·Lauren N BowenAvindra Nath

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Citations

Oct 22, 2020·Journal of Neurology·Dimitri RenardJean Sebastien Guillamo

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