Chanet Valérie, Baud Olivier, Deffond Didier, Romaszko Jean-Pierre, Beytout Jean
Infectious Diseases Department, Hôtel-Dieu, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
South Med J. 2005 Apr;98(4):489-91. doi: 10.1097/01.SMJ.0000152544.47644.25.
Diagnosis of tuberculoma is difficult because of its tumorlike aspects. This report describes the case of a male who displayed a hemiplegia revealing an intracranial mass. Neuroimaging was consistent with a glioblastoma; however, the definite diagnosis was a tuberculoma. Clinical features of tuberculomas are nonspecific. Even though the neuroimaging features are sensitive, they are much less specific, with variability related to the tuberculoma course. Investigations leading to the diagnosis are histologic analysis showing a granuloma with or without caseating necrosis, and the microbiologic identification of Mycobacterium tuberculosis. Every intracranial tumor with malignant radiologic and clinical appearance must evoke a suspicion for tuberculoma.
由于结核瘤具有肿瘤样表现，其诊断较为困难。本报告描述了一例男性患者，该患者出现偏瘫，提示颅内有肿物。神经影像学表现与胶质母细胞瘤相符；然而，最终诊断为结核瘤。结核瘤的临床特征不具有特异性。尽管神经影像学特征较为敏感，但特异性却低得多，且与结核瘤病程相关存在变异性。确诊的检查包括组织学分析显示有或无干酪样坏死的肉芽肿，以及结核分枝杆菌的微生物学鉴定。每一例具有恶性放射学和临床外观的颅内肿瘤都必须怀疑为结核瘤。
