43 years Female (DOB:3/22/1973)Reason: 43 yo with HIV and AMS eval for infection vs lymphoma History: alteredPROVIDER/ATTENDING NAME: DANA P EDELSON DANA P EDELSON The CSF spaces are appropriate for the patient's stated age with no midline shift. There is subtle diffuse periventricular and ill-defined signal hyperintensity without associated contrast enhancement. There is some associated involvement of the cerebral peduncles and internal capsules and some scattered involvement in the cerebellum and rest of the brainstem.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate partial opacification of the right sphenoid sinus and some mucosal thickening in the maxillary sinuses.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.There is diffuse marrow replacement present.
1.There is subtle signal change within the periventricular white matter and internal capsule with some lesser associated involvement of the brainstem and cerebellum. This is nonspecific. One possibility is that this represents HIV infection. No focal lesions are appreciated to suggest lymphoma.2.Diffuse marrow replacement is suspected to be related to HIV status.