Primary central nervous system lymphoma as a neuromanifestation in AIDS patients

In patients infected with human immunodeficiency virus (HIV), the risk of d eveloping non-Hodgkin's lymphoma is over 100 times greater than with noninf ected persons. Primary central nervous system lymphoma as a complication of the acquired immunodeficiency syndrome (AIDS) occurs in up to 2.4% of all cases and is strongly associated with the Epstein-Barr virus. The prognosis is very poor, with a mean survival time of 21 to 27 days without therapy a nd up to 119 days with radiation therapy. We describe the course of seven A IDS patients with histologically proven primary central nervous system lymp homa and present a review of clinical symptoms, diagnosis, and therapy. The main criteria for differential diagnosis from other secondary neuromanifes tations such as cerebral toxoplasmosis, progressive multifocal leukoencepha lopathy, abscesses, and infarctions are described.