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Ira C. Denton, Jr, MD; Edwin A. Stevens, MD; Steven M. Seidenfeld, MD; Charles R. Cramer, MD; Jon W. Esber, MD; S. Beck Weathers, MD
Medical City Dallas Hospital

JAMA. 1985;253(23):3398.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

We wish to comment on the observations of Elkin et al¹ and to address specifically the topic of biopsy of intracranial lesions in patients with the acquired immunodeficiency syndrome (AIDS).

With the availability of computed tomographic (CT) scan—directed stereotactic surgical systems, we no longer consider clinical and roentgenographic criteria sufficient for the diagnosis and treatment of most patients with AIDS who have intracranial lesions. As the authors note, the varieties of pathogens and neoplasms known to affect patients with AIDS range from the ordinary to the bizarre, and different processes may coexist. Unfortunately, the brain's rather stereotypical mechanisms of response to this host of potential challenges result in CT images of limited diagnostic specificity; dissimilar processes thus may mimic one another. In an area of such complexity, diagnostic accuracy requires an analysis of biopsy material. Therapy based on clinical and roentgenographic criteria alone must be reserved . . . [Full Text PDF of this Article]

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