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Toxoplasma Encephalitis in Atypical Hosts at an Academic Cancer Center.

Morjaria S, Epstein DJ, Romero FA, Taur Y, Seo SK, Papanicolaou GA, Hatzoglou V, Rosenblum M, Perales MA, Scordo M, Kaltsas A - Open Forum Infect Dis (2016)

Bottom Line: Toxoplasma encephalitis is a well recognized complication of acquired immune deficiency syndrome, solid organ transplantation, and allogeneic hematopoietic stem cell transplantation (HSCT).However, patients with hematologic malignancies not treated with allogeneic HSCT may also develop this condition, which requires high clinical suspicion and consideration for prophylactic therapy.

View Article: PubMed Central - PubMed

Affiliation: Infectious Disease Service, Department of Medicine.

ABSTRACT
Toxoplasma encephalitis is a well recognized complication of acquired immune deficiency syndrome, solid organ transplantation, and allogeneic hematopoietic stem cell transplantation (HSCT). However, patients with hematologic malignancies not treated with allogeneic HSCT may also develop this condition, which requires high clinical suspicion and consideration for prophylactic therapy.

No MeSH data available.


Related in: MedlinePlus

(A) Toxoplasma cyst forms (circled) and tachyzoites (arrows) are seen bordering a focus of necrosis (hematoxylin and eosin, ×100). (B) Labeling with anti-Toxoplasma antibody confirms the nature of the cyst forms and tachyzoites (anti-Toxoplasma immunohistochemistry with hematoxylin counterstain, ×100). (C) An axial T1-weighted image obtained after intravenous contrast injection demonstrates a ring-enhancing toxoplasmosis lesion in the right caudate nucleus measuring 1.2 × 0.8 cm.
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OFW070F1: (A) Toxoplasma cyst forms (circled) and tachyzoites (arrows) are seen bordering a focus of necrosis (hematoxylin and eosin, ×100). (B) Labeling with anti-Toxoplasma antibody confirms the nature of the cyst forms and tachyzoites (anti-Toxoplasma immunohistochemistry with hematoxylin counterstain, ×100). (C) An axial T1-weighted image obtained after intravenous contrast injection demonstrates a ring-enhancing toxoplasmosis lesion in the right caudate nucleus measuring 1.2 × 0.8 cm.

Mentions: Initial brain histology from stereotactic needle biopsy sampling of the right frontal lobe lesion revealed only an atypical lymphoid infiltrate. A right frontal craniotomy with open brain biopsy was pursued. Histologic examination of the neurosurgical material demonstrated cerebral involvement by both LYG and active toxoplasmosis. The former process was characterized by a polymorphous mononuclear cell infiltrate that included a subpopulation of enlarged and atypical B lymphocytes exhibiting immunohistochemical expression of CD19, CD20, and CD30, but not CD3 or CD15. In situ hybridization studies demonstrated kappa light chain restriction and the presence of lymphocyte labeling for EBV-encoded RNA (EBER1). Involvement of blood vessel walls was conspicuous, as were large zones of necrosis. Bradyzoite-laden cysts and tachyzoites, confirmed by positive labeling on immunohistochemical study, were identified mainly in tissues adjoining areas of necrosis (Figure 1A and 1B).Figure 1.


Toxoplasma Encephalitis in Atypical Hosts at an Academic Cancer Center.

Morjaria S, Epstein DJ, Romero FA, Taur Y, Seo SK, Papanicolaou GA, Hatzoglou V, Rosenblum M, Perales MA, Scordo M, Kaltsas A - Open Forum Infect Dis (2016)

(A) Toxoplasma cyst forms (circled) and tachyzoites (arrows) are seen bordering a focus of necrosis (hematoxylin and eosin, ×100). (B) Labeling with anti-Toxoplasma antibody confirms the nature of the cyst forms and tachyzoites (anti-Toxoplasma immunohistochemistry with hematoxylin counterstain, ×100). (C) An axial T1-weighted image obtained after intravenous contrast injection demonstrates a ring-enhancing toxoplasmosis lesion in the right caudate nucleus measuring 1.2 × 0.8 cm.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834739&req=5

OFW070F1: (A) Toxoplasma cyst forms (circled) and tachyzoites (arrows) are seen bordering a focus of necrosis (hematoxylin and eosin, ×100). (B) Labeling with anti-Toxoplasma antibody confirms the nature of the cyst forms and tachyzoites (anti-Toxoplasma immunohistochemistry with hematoxylin counterstain, ×100). (C) An axial T1-weighted image obtained after intravenous contrast injection demonstrates a ring-enhancing toxoplasmosis lesion in the right caudate nucleus measuring 1.2 × 0.8 cm.
Mentions: Initial brain histology from stereotactic needle biopsy sampling of the right frontal lobe lesion revealed only an atypical lymphoid infiltrate. A right frontal craniotomy with open brain biopsy was pursued. Histologic examination of the neurosurgical material demonstrated cerebral involvement by both LYG and active toxoplasmosis. The former process was characterized by a polymorphous mononuclear cell infiltrate that included a subpopulation of enlarged and atypical B lymphocytes exhibiting immunohistochemical expression of CD19, CD20, and CD30, but not CD3 or CD15. In situ hybridization studies demonstrated kappa light chain restriction and the presence of lymphocyte labeling for EBV-encoded RNA (EBER1). Involvement of blood vessel walls was conspicuous, as were large zones of necrosis. Bradyzoite-laden cysts and tachyzoites, confirmed by positive labeling on immunohistochemical study, were identified mainly in tissues adjoining areas of necrosis (Figure 1A and 1B).Figure 1.

Bottom Line: Toxoplasma encephalitis is a well recognized complication of acquired immune deficiency syndrome, solid organ transplantation, and allogeneic hematopoietic stem cell transplantation (HSCT).However, patients with hematologic malignancies not treated with allogeneic HSCT may also develop this condition, which requires high clinical suspicion and consideration for prophylactic therapy.

View Article: PubMed Central - PubMed

Affiliation: Infectious Disease Service, Department of Medicine.

ABSTRACT
Toxoplasma encephalitis is a well recognized complication of acquired immune deficiency syndrome, solid organ transplantation, and allogeneic hematopoietic stem cell transplantation (HSCT). However, patients with hematologic malignancies not treated with allogeneic HSCT may also develop this condition, which requires high clinical suspicion and consideration for prophylactic therapy.

No MeSH data available.


Related in: MedlinePlus