CTICasesPulmonary Pneumocystis jirovecii Pneumonia and Cerebral Lymphoproliferative Disorder in HIV
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Imaging findings
Chest CT reveals extensive, small cavitary lesions and cavitary nodules located predominantly in the anterior portions of both lungs, along with small nodular and tubular opacities in the lower lung zones. Brain MRI demonstrates multiple enhancing cerebral lesions.
Key takeaways
While Pneumocystis jirovecii pneumonia (PJP) classically presents as bilateral ground-glass opacities, atypical manifestations such as multiple small, discrete cavitary lesions, cavitary nodules, and tree-in-bud-like opacities can occur, especially in severely immunocompromised HIV patients. Concurrent enhancing brain lesions in an HIV-positive patient may represent opportunist infections like toxoplasmosis or lymphoproliferative disorders such as HIV-associated lymphoproliferative disorder.
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