PMC10205443_01
Rim enhancing lesion in the left frontal lobe with extensive surrounding vasogenic edema, associated with restricted diffusion within the brain shown with arrows in DWI [A], axial ADC [B], axial T1 [C], and FLAIR [D] sequences of MRI brain without contrast. DWI = diffusion weighted imaging; ADC = apparent diffusion coefficient; MRI = magnetic resonance imaging.
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Given abnormal CT head findings, a magnetic resonance imaging (MRI) of the brain was done and revealed peripherally enhancing lesions in the left frontal and occipital lobes (Fig. 1, Fig. 2), which was thought to be consistent with metastases.
Microscopic examination (magnification x 400, hematosylin and eosin stain) of a biopsy of the left frontal lobe reveals encysted forms (arrow) and multiple free tachyzoites (arrowhead). Background brain parenchyma with reactive gliosis.
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He underwent an image-guided biopsy of the left frontal lobe lesion and microscopic examination revealed microorganisms consistent with Toxoplasma gondii (Fig. 3, Fig. 4).