Matsumoto Yoshihisa, Aikawa Hiroshi, Narita Sumito, Tsutsumi Masanori, Yoshida Hidenori, Etou Housei, Sakamoto Kimiya, Inoue Ritsuro, Nii Kohei, Kazekawa Kiyoshi
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Fukuoka 818-8502, Japan.
Neurol Med Chir (Tokyo). 2013;53(4):259-62. doi: 10.2176/nmc.53.259.
The rise in the incidence of tuberculosis is generally related to human immunodeficiency virus infection. However, intracranial tuberculoma, a complication of tuberculosis considered to be a critical disease, can develop even in the absence of immunosuppressive state. Here, we describe 2 cases of intracranial tuberculoma occurring in patients with no evidence of immunosuppressive state or past history of tuberculosis. In Case 1, lesions were observed in the right lateral ventricle, with histological examination revealing granulomatous lesions. In Case 2, scattered lesions were observed in the cranium and the lung fields. In both cases, the QuantiFERON Test (QFT) was positive, and improvements were observed in the symptoms following administration of antituberculous drugs. Intracranial tuberculoma cannot be considered rare, and needs to be included in the differential diagnosis of intracranial lesions. Diagnosis can be tricky since this disease can develop in a patient in a non-immunosuppressive state or without a past history of tuberculosis. The QFT is an effective test to enable the diagnosis of tuberculomas in atypical patients.
结核病发病率的上升通常与人类免疫缺陷病毒感染有关。然而，颅内结核瘤作为结核病的一种并发症被视为一种严重疾病，即使在没有免疫抑制状态的情况下也可能发生。在此，我们描述2例颅内结核瘤病例，这2例患者均无免疫抑制状态证据或既往结核病史。病例1中，在右侧脑室观察到病变，组织学检查显示为肉芽肿性病变。病例2中，在颅骨和肺野观察到散在病变。两例患者的全血γ干扰素释放试验（QFT）均为阳性，给予抗结核药物治疗后症状均有改善。颅内结核瘤不能被视为罕见病，需要纳入颅内病变的鉴别诊断。由于这种疾病可在非免疫抑制状态或无既往结核病史的患者中发生，因此诊断可能具有挑战性。QFT是一种有效的检测方法，可用于诊断非典型患者的结核瘤。
