En Plaque Tuberculoma: a Case Report
- Affiliations
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- 1Department of Radiology, Seoul Medical Center, Seoul, Korea. jnoon276@gmail.com
- KMID: 2354803
- DOI: http://doi.org/10.13104/imri.2016.20.3.200
Abstract
- In Korea, tuberculosis is still common disease. Central nervous system tuberculosis can manifest in a variety of forms, including tuberculous meningitis, tuberculous cerebritis, tuberculoma, tuberculous abscess, and miliary tuberculosis. Although intra-axial tuberculomas are the more common type of CNS tuberculosis, extra-axial lesions are rarely encountered. En plaque tuberculoma is an extremely rare presentation of intracranial tuberculosis with mimicking primary or secondary meningeal neoplasia. We describe a rare case of an en plaque tuberculoma accompanied by tuberculous meningitis and tuberculomas.
MeSH Terms
Figure
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Fig. 1 A 73-year-old woman with an en plaque tuberculoma. (a) CT scan showed iso to hyperattenuating lesion at left temporal extra-axial space with low density area in the Lt. temporal lobe. (b) DWI showed iso to low signal intensity lesion at left temporal extra-axial space. (c) T2-weighted axial MRI showed iso-signal intensity lesion with perilesional high signal intensity. (d-f) T1-weighted axial (d) MRI showed iso-signal intensity lesion with contrast-enhanced T1-weighted axial (e) and coronal (f) MRI showing homogeneous enhancing dural-based lesion in the left temporal convexity (arrows).
Fig. 2 Contrast-enhanced T1-weighted axial (a) and coronal (b) MRI showed multiple ring and nodular enhancing lesions in the cortico-sulcal area of the right medial frontoparietal lobe and left paramedian cerebellum (c). Some of these showed dark signal intensity on SWI (d).
Fig. 3 Follow-up MRI (4 weeks later) contrast-enhanced T1-weighted axial (a) and coronal (b) MRI, showed a marked decrease in the extent of the plaque-like enhancing mass of the left temporal subdural space (arrows). Also multiple tuberculomas in the right high frontoparietal cortico-sulcal area (c) and left paramedian cerebellum (d), showed a marked decrease in size and number on contrast-enhanced T1-weighted axial MRI.
Reference
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