TY  - JOUR
T1  - STereotactic brain biopsy in human immunodeficiency virus—infected patients
AU  - Luzzati R, Ferrari S, Nicolato A, et al
Y1  - 1996/03/11
N1  - 10.1001/archinte.1996.00440050123013
JO  - Archives of Internal Medicine
SP  - 565
EP  - 568
VL  - 156
IS  - 5
N2  - Objective: 
    To evaluate prospectively the diagnostic efficacy and safety of stereotactic brain biopsy and its impact on treatment, outcome, and survival in human immunodeficiency virus—infected patients with focal brain lesions.Methods: 
    Computed tomography—guided stereotactic brain biopsy was performed in 26 patients, of whom 17 failed to respond to a 2- to 3-week anti-Toxoplasma regimen. Exclusion criteria for biopsy were overt acquired immunodeficiency syndrome for 2 years or longer, Karnofsky score less than 50, and severe coagulopathies.Results: 
    A definitive diagnosis was obtained in 24 patients (92%), of whom 12 (46%) had primary brain lymphoma, six (23%) had progressive multifocal leukoencephalopathy, and four (15%) had Toxoplasma encephalitis. Two thirds of contrast-enhancing lesions on computed tomography were lymphoma and three fourths of contrast-negative lesions were leukoencephalopathy. Three patients had biopsy-related cerebral hemorrhages (morbidity, 11.5%). Median follow-up and survival for the entire group were 24 weeks (range, 6 to 135 weeks). Twenty patients (77%) received specific therapy and 13 (50%) responded to treatment. Of 11 patients with lymphoma undergoing irradiation treatment (whole-brain radiotherapy in seven and γ-knife treatment in four), nine (82%) had clinical and radiologic response, with a median survival of 34 weeks (range, 13 to 57 weeks).Conclusions: 
    Stereotactic brain biopsy has high diagnostic efficacy and clinical benefit in carefully selected human immunodeficiency virus—infected patients. The procedure should be performed essentially in patients with contrast-enhancing lesions on computed tomography who have a high frequency of treatable cerebral diseases.(Arch Intern Med. 1996;156:565-568)
SN  - 0003-9926
M3  - doi: 10.1001/archinte.1996.00440050123013
UR  - http://dx.doi.org/10.1001/archinte.1996.00440050123013
ER  -