Asriyani Sri, Syahril Erlin
Department of Radiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
J Clin Imaging Sci. 2022 Jun 3;12:30. doi: 10.25259/JCIS_212_2021. eCollection 2022.
Tuberculoma is a space-occupying lesion resulting from the containment of the inflammatory process in metastatic tuberculosis, which most commonly occur in the brain and lungs. This form of tuberculosis is commonly found in adults, but rarely seen in children. Here we reported a case of an infant with multiple organ tuberculomas. The patient had unspecific signs and symptoms. There were also multiple cervical lymph nodes enlargement and weakness in both lower limbs and right hand. Chest radiograph showed a left pulmonary mass which was further evaluated by thorax CT imaging and revealed pulmonary tuberculoma, mediastinal lymphadenopathies, and pneumonia. Cervical ultrasound showed multiple cervical lymphadenites and brain MRI with contrast showed multiple intracranial tuberculomas with focal meningitis. A microscopic examination from gastric lavage sampling revealed a positive acid-fast bacillus smear and a biopsy of a lump in the neck demonstrated a picture of chronic granulomatous lymphadenitis that supports tuberculosis infection. Through this case, we emphasize the importance of the various appearance of pulmonary and extrapulmonary tuberculosis in infants.
结核瘤是转移性肺结核中炎症过程局限化形成的占位性病变,最常见于脑和肺。这种肺结核形式常见于成人,儿童罕见。在此我们报告一例患有多器官结核瘤的婴儿病例。该患者有非特异性体征和症状。还存在多个颈部淋巴结肿大以及双下肢和右手无力。胸部X线片显示左肺有肿块,通过胸部CT成像进一步评估发现肺结核瘤、纵隔淋巴结肿大和肺炎。颈部超声显示多个颈部淋巴结炎,增强脑MRI显示多个颅内结核瘤伴局灶性脑膜炎。胃灌洗样本的显微镜检查显示抗酸杆菌涂片阳性,颈部肿块活检显示慢性肉芽肿性淋巴结炎图像,支持结核感染。通过该病例,我们强调婴儿肺和肺外结核各种表现的重要性。