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Int J Clin Exp Pathol 2010;3(1):106-109
Case Report
Asymptomatic Diffuse “Encephalitic” Cerebral Toxoplasmosis in a Patient with Chronic
Lymphocytic Leukemia: Case Report and Review of the Literature
Malak Abedalthagafi, Elisabeth J Rushing, David Garvin, Bruce Cheson and Metin Ozdemirli
Departments of Pathology1 and Hematology/Oncology2, Georgetown University Hospital, 3900 Reservoir Road, N.W, Washington DC, USA and
3Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington DC, USA
Received 8 February 2009; Accepted in revision 4 March 2009; Available online 15 March 2009
Abstract: Opportunistic infections account for the majority of central nervous system lesions in adult immunosuppressed patients. In this
setting, toxoplasmosis typically manifests as multiple abscesses readily seen on routine neuroimaging studies. Asymptomatic, widely
disseminated Toxoplasma cysts without parenchymal reaction are also recognized. In contrast, widespread parasites in the brain parenchyma
with an inflammatory “encephalitic” reaction and little or no necrosis have been reported in only four patients with acquired immune deficiency
syndrome (AIDS). We describe a 70 year old male with stage IV chronic lymphocytic leukemia complicated by aplastic anemia. Neurological
examination and imaging revealed no significant abnormalities. At autopsy, the brain revealed multifocal cysts and free tachyzoites of
Toxoplasma gondii with diffuse microglial nodules and no necrosis. To the best of our knowledge, this case represents the first report of the
"encephalitic" form of toxoplasmosis in a non-AIDS patient. (IJCEP902003).
Key Words: Toxoplasmosis, chronic lymphocytic leukemia, central nervous system, Toxoplasma
Full text PDF
Address all correspondence to:
Malak Abedalthagafi, M.D.,
Department of Pathology
Georgetown University Hospital
3900 Reservoir Road, N.W.
Washington DC, 20007.
Tel: 202-784-3637; Fax: 202-687-8935;
Email: mxa212@gunet.georgetown.edu
Case Report
Asymptomatic Diffuse “Encephalitic” Cerebral Toxoplasmosis in a Patient with Chronic
Lymphocytic Leukemia: Case Report and Review of the Literature
Malak Abedalthagafi, Elisabeth J Rushing, David Garvin, Bruce Cheson and Metin Ozdemirli
Departments of Pathology1 and Hematology/Oncology2, Georgetown University Hospital, 3900 Reservoir Road, N.W, Washington DC, USA and
3Department of Neuropathology and Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington DC, USA
Received 8 February 2009; Accepted in revision 4 March 2009; Available online 15 March 2009
Abstract: Opportunistic infections account for the majority of central nervous system lesions in adult immunosuppressed patients. In this
setting, toxoplasmosis typically manifests as multiple abscesses readily seen on routine neuroimaging studies. Asymptomatic, widely
disseminated Toxoplasma cysts without parenchymal reaction are also recognized. In contrast, widespread parasites in the brain parenchyma
with an inflammatory “encephalitic” reaction and little or no necrosis have been reported in only four patients with acquired immune deficiency
syndrome (AIDS). We describe a 70 year old male with stage IV chronic lymphocytic leukemia complicated by aplastic anemia. Neurological
examination and imaging revealed no significant abnormalities. At autopsy, the brain revealed multifocal cysts and free tachyzoites of
Toxoplasma gondii with diffuse microglial nodules and no necrosis. To the best of our knowledge, this case represents the first report of the
"encephalitic" form of toxoplasmosis in a non-AIDS patient. (IJCEP902003).
Key Words: Toxoplasmosis, chronic lymphocytic leukemia, central nervous system, Toxoplasma
Full text PDF
Address all correspondence to:
Malak Abedalthagafi, M.D.,
Department of Pathology
Georgetown University Hospital
3900 Reservoir Road, N.W.
Washington DC, 20007.
Tel: 202-784-3637; Fax: 202-687-8935;
Email: mxa212@gunet.georgetown.edu
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