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  • Title: [Two case mimicking cerebral tuberculoma in MRI diffusion weighted-images with difficult preoperative diagnosis].
    Author: Nisikawa W, Takemoto K, Sakamoto S, Yamamoto M, Fukushima T, Utsunomiya H, Takano K.
    Journal: No To Shinkei; 2006 Aug; 58(8):695-700. PubMed ID: 16986676.
    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.
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