Cerebellum, Tuberculoma [LMP63698]

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Image Details
Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Infectious Diseases
Diagnosis: 
Tuberculoma
Species: 
Human
Organ System: 
Central Nervous System
Gender: 
Female
Age: 
39 years
Diagnosis Code: 
ICD-10: A17.8
Slide Contributor Information
Gao, A., Keith, J.

Keywords

Mycobacterium tuberculosis, granuloma, tuberculosis, TB

Clinical History

39-year-old woman with headache. Neuroimaging shows ring-enhancing cerebellar mass.

Clinical Discussion

Tuberculosis can affect the CNS in a diffuse (meningitis) or localized (tuberculoma) manner, most commonly in immunocompromised patients or those from endemic countries. Tuberculomas present as a mass that may reach several centimeters in size. Grossly, it has a cheese-like, “caseous” appearance. Microscopically, the centre of the tuberculoma consists of necrosis, whereby dead cells appear as amorphous, eosinophilic, granular material. There is a surrounding rim of epithelioid histiocytes, lymphocytes, plasma cells, and multinucleated giant cells (usually Langhans type). Acid fast bacilli may or may not be demonstrable by Ziehl-Neelsen stain. Prognosis is variable and depends on the promptness of treatment.