USEFULNESS OF BRAIN BIOPSY IN FOCAL CEREB RAL-LESIONS IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Brain mass lesions (BML) occurred in 10% of patients infected by the h uman immunodeficiency virus (HIV), as expression of severe and sometim es treatable diseases. However, the management of them is not well est ablished. We analyzed, retrospectively, 26 brain biopsies (22 estereot axic) in patients with HIV infection and BML to know their usefulness and safety. The inclusion criteria were: Failure of the anti-Toxoplasm a empirical treatment, atypical scan appearance for toxoplasmosis, or severe neurological picture. Brain biopsy yielded a diagnosis in 19 pa tients (73.1%): Progressive multifocal leukoencephalopathy (n = 8; 30. 8%), primary central nervous system lymphoma (n = 6; 23.1%), mycobacte riosis (n = 2; 7.7%), toxoplasmosis (n = 2; 7.7%), criptococcosis (n = 1), cryptosporidiosis (n = 1) and HIV-encephalitis (n = 1). In one ca se there was a multiple diagnosis: mycobacteriosis, toxoplasmosis, and lymphoma. Blain biopsy results decided a change In therapy in 65.4%, the resolution or improvement of the neurological process in 30.8%, an d the determination of the prognosis in 30.8%. In 8 cases (30.7%) ther e were biopsy complications, with secondary mortality in one. Brain bi opsy of BML in HIV-infected patients is a diagnostic method with a hig h overall diagnostic rentability and uncommon non reversible complicat ions, offering the possibility to prescribe a specific and potentially curative treatment.