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Case Reports
. 2017 Jun 28;9(6):e1405.
doi: 10.7759/cureus.1405.

The Importance of a Complete Differential: Case Report of a Tuberculoma in a Patient without Pulmonary Involvement

Pooja Sethi  1 , Jennifer Treece  2 , Chidinma Onweni  2 , Vandana Pai  2 , Zia Rahman  2 , Siddharth Singh  3
Affiliations
Case Reports

The Importance of a Complete Differential: Case Report of a Tuberculoma in a Patient without Pulmonary Involvement

Pooja Sethi et al. Cureus. .

Abstract

Patients with a tuberculoma typically present with pulmonary involvement of tuberculosis and have risk factors for tuberculosis (TB). The risk factors for tuberculosis include bacillary load, proximity to infectious case, immunosuppressive conditions, malnutrition, young age, diabetes mellitus, working in healthcare, recent incarceration, alcohol use, and tobacco use. Although rare, it is possible for a patient to present with a tuberculoma despite the absence of risk factors for tuberculosis other than diabetes and without pulmonary involvement.

Keywords: brain mass; headache; ring-enhancing lesion; tuberculoma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. MRI of the brain (sagittal view) shows a large right cerebellar ring-enhancing lesion indicated by the arrow.
MRI of the brain from the side (sagittal view) shows a large ring-enhancing mass in the cerebellum, which is seen as an irregular oval-appearing lesion with a bright white outline and is indicated by the arrow. MRI - magnetic resonance imaging.
Figure 2
Figure 2. MRI of the brain (coronal view) shows a right cerebellar ring-enhancing lesion.
MRI of the brain from a vertical, frontal plan (coronal view) showing a large (25.3 mm diameter) ring-enhancing lesion in the patient's cerebellum, which is indicated by the arrow. MRI - magnetic resonance imaging.
Figure 3
Figure 3. Necrotizing granulomas on histopathology
Dissection of the large ring-enhancing lesion removed from the patient's cerebellum showed necrotizing granuloma when the tissue was viewed under the microscope. The pink central area is necrosis, indicated by the black arrow, with surrounding epithelioid histocytes, indicated by the red arrow. Necrotizing granuloma is found in tuberculosis.
See this image and copyright information in PMC

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