title: [Two case mimicking cerebral tuberculoma in MRI diffusion weighted-images with difficult preoperative diagnosis].
abstract: Two cases with a high signal intensity core with laminar structure based on diffusion weighed-images (DWI) mimicking intracerebral tuberculoma were herein reported. Both patients were suspected to have pulmonary tuberculosis in their past history and/or based on chest X-ray findings. DWI demonstrated a high signal intensity core with laminar structure, thus suggesting the presence of an intracerebral tuberculoma. As initial therapy, both patients received anti-tuberculous drugs, however, their symptoms did not improve, and the lesions were observed to have increased in MRI. As a result, a biopsy was carried out to clarify the nature of the disease. A pathological examination showed the former to be a brain abscess while the latter was metastatic carcinoma. In such cases mimicking intracerbral tuberculoma based on DWI, anti-tuberculous drugs are first treatment of choice, however, a biopsy should be performed as early as possible if the medication dose not show a significant response.
authors.affiliation: Department of Neurosurgery, Fukuoka University School of Medicine, Fukuoka-city, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Nisikawa
authors.forename: Kouichiro
authors.initials: K
authors.lastname: Takemoto
authors.forename: Seizaburo
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Takeo
authors.initials: T
authors.lastname: Fukushima
authors.forename: Hidetsuna
authors.initials: H
authors.lastname: Utsunomiya
authors.forename: Kouichi
authors.initials: K
authors.lastname: Takano
mesh_terms: D000368:Aged; D001706:Biopsy; D001921:Brain / Q000473:pathology*; D001922:Brain Abscess / Q000175:diagnosis*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016862:Tuberculoma, Intracranial / Q000175:diagnosis*