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Abstract Some non-neoplastic lesions may induce proliferation of immune system cells and glial tissue, resulting in a spectral pattern similar to neoplasms: (136) 1. Inflammatory pseudotumor. 2. Organizing hematoma. 3. Encephalitis secondary to herpes virus type 6.This is a subacute encephalitis, in which there is a parenchymal lesion similar to an infiltrative neoplastic process, associated with a marked increase in Cho levels. Elevations in Cho levels in inflammatory processes likely arise from gliosis. It is also common to observe increased mI levels that may be used to distinguish encephalitis from a highgrade neoplasm. Significant increases in Glx levels are also more characteristic of inflammatory processes. (28) 4. Fulminate acute demyelination, group of patients with demyeliniating diseasewho present with an acute or subacute focal neurologic deficit but who may not develop multiple sclerosis in its full form. In cMRI, the lesions of these patients tend to be single, large and with a mass-like appearance. They may be submitted to biopsy, surgical excision, or even radiotherapy because the pathologic analysis may mistakenly suggest neoplasm. The distinction between a single acute demyelination plaque and glioma is often a challenge. The spectral analysis of an acute plaque could suggest neoplasm because an increase in lipids, lactate, and Choline levels are observed. (28,137, 138) |