title: Mycobacterial spindle cell pseudotumor of the brain: a case report and review of the literature.
abstract: Spindle cell pseudotumors found in the skin, lymph nodes, bone marrow, spleen, lungs, and retroperitoneum have been reported recently in immunosuppressed patients, including those with acquired immunodeficiency syndrome. The authors report a similar lesion limited to the brain in a 38-year-old human immunodeficiency virus-negative man receiving steroid therapy for treatment of sarcoidosis. Histopathologically the lesions were composed of spindle and epithelioid histiocytes, small foci of necrosis, and numerous acid-fast bacilli. The acid-fast bacilli were determined by culture and polymerase chain reaction to be Mycobacterium avium intracellulare. Because of the uncommon histologic appearance of this lesion and the potential for treatment if recognized, mycobacterial spindle cell pseudotumors should be included in the differential diagnosis of spindle cell lesions in the brain in immunosuppressed patients.
authors.affiliation: Armed Forces Institute of Pathology, Department of Neuropathology, Washington, DC 20306-6000, USA.
authors.forename: A
authors.initials: A
authors.lastname: Morrison
authors.forename: K A
authors.initials: KA
authors.lastname: Gyure
authors.forename: J
authors.initials: J
authors.lastname: Stone
authors.forename: K
authors.initials: K
authors.lastname: Wong
authors.forename: P
authors.initials: P
authors.lastname: McEvoy
authors.forename: K
authors.initials: K
authors.lastname: Koeller
authors.forename: H
authors.initials: H
authors.lastname: Mena
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D001932:Brain Neoplasms / Q000175:diagnosis; D020806:Central Nervous System Bacterial Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D006801:Humans; D016867:Immunocompromised Host; D007150:Immunohistochemistry; D008297:Male; D015269:Mycobacterium avium Complex / Q000235:genetics / Q000302:isolation & purification*; D015270:Mycobacterium avium-intracellulare Infection / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D004269:DNA, Bacterial