Clinicopathological study of tuberculous brain abscess.
Central nervous system tuberculosis is still one of the leading causes of morbidity in the developing world, and tuberculous abscess is one of its uncommon manifesting forms. It closely mimics a pyogenic abscess clinically, radiologically, and histologically. An accurate diagnosis is imperative due to therapeutic implications. In this study, 21 cases of tuberculous abscesses encountered over a period of 13 years (1995-2007) were reviewed to study the clinical, radiological, and histopathological spectrum of the disease. The presence of palisading epithelioid cells and sheets of foamy histiocytes, enclosing a neutrophillic exudate rich in fibrin with nuclear debris, were clues as to suspicion of a tuberculous abscess. The demonstration of acid fast bacilli in the wall of the abscess or necrotic contents by microscopy or culture is essential to confirm the diagnosis of tuberculous abscess. A high index of clinical suspicion is necessary particularly in countries endemic for tuberculosis to ensure an accurate diagnosis and application of an appropriate therapy.
Chakraborti
Shrijeet
S
Department of Neuropathology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
Mahadevan
Anita
A
Govindan
Aparna
A
Nagarathna
S
S
Santosh
Vani
V
Yasha
T C
TC
Devi
B Indira
BI
Chandramouli
B A
BA
Kovoor
Jerry M E
JM
Chandramuki
A
A
Shankar
S K
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D001431:Bacteriological Techniques; D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D015622:Epithelioid Cells / Q000473:pathology; D005260:Female; D006644:Histiocytes / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009336:Necrosis; D009504:Neutrophils / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016862:Tuberculoma, Intracranial / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D055815:Young Adult