[Two case mimicking cerebral tuberculoma in MRI diffusion weighted-images with difficult preoperative diagnosis].
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.
Nisikawa
Wataru
W
Department of Neurosurgery, Fukuoka University School of Medicine, Fukuoka-city, Japan.
Takemoto
Kouichiro
K
Sakamoto
Seizaburo
S
Yamamoto
Masaaki
M
Fukushima
Takeo
T
Utsunomiya
Hidetsuna
H
Takano
Kouichi
K
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*