Multiple Intracranial Tuberculomas Mimicking Granulocytic Sarcomas in Acute Myeloid Leukemia
Journal of Korean Medical Science
;
: S171-S173, 2007.
Article
in English
| WPRIM
| ID: wpr-209036
ABSTRACT
The diagnosis of incracranial tuberculoma in immune-compromised hosts is often difficult because conventional magnetic resonance (MR) imaging of tuberculoma reveals various findings and neurologic symptoms are not typical. Here, we report a case of a 54-yr old man with multiple intracranial tuberculoma who was treated for acute myeloid leukemia. He complained of right-side paresthesia after the third consolidation chemotherapy without leukemic relapse and fever. MR imaging of the brain showed multiple ring-enhanced lesions in the cerebrum, cerebellar hemisphere, and pons. The lesions appeared to mimic a metastatic tumor or abscess. Cerebrospinal fluid analysis showed no abnormal cells, but the level of adenosine deaminase was elevated (28.8 IU/L, normal 0-8). Stereotactic brain biopsy was performed, but only reactive gliosis was observed. To confirm diagnosis, an open brain biopsy was performed. The histopathology demonstrated chronic granulomatous inflammation with caseous necrosis. Tuberculous-polymerase chain reaction of the biopsy showed a positive result. He was treated with anti-tuberculosis medication and a high dose of steroid. Paresthesia improved, and follow-up brain MR imaging showed the decreased size and numbers of ring-enhanced lesions and improvement of perilesional edema 1 month after treatment. Here, we report on an interesting case of intracranial tuberculoma in acute myeloid leukemia.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Brain Neoplasms
/
Magnetic Resonance Imaging
/
Leukemia, Myeloid, Acute
/
Tuberculoma, Intracranial
/
Sarcoma, Myeloid
/
Diagnosis, Differential
/
Antitubercular Agents
Type of study:
Diagnostic study
Limits:
Humans
/
Male
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2007
Type:
Article
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