En-Plaque Central Nervous System Tuberculoma - An Uncommon Entity: Clinico-Radiological Profile in a Cohort from a Tertiary Referral Centre

Srikanteswara, Praveen Kumar; Pampapati, Praveen Kumar; Yelsangikar, Kalpana Ramesh

doi:10.7860/jcdr/2016/20608.7940

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…Radiologic features of en plaque tuberculomas include appearing hyperdense on noncontrast CT scans, isointense to the brain on T1WI, and isointense to hypointense to the brain on T2WI with homogeneous post-contrast enhancement (6, 7). However, Srikanteswara et al fossa (6). However, similar imaging findings can be seen in various cases of inflammatory and non-inflammatory conditions, showing dural-based lesions, the most common being meningiomas (5,7).…”

Section: Discussionmentioning

confidence: 84%

“…Also, when the meningeal inflammation is confined, it forms a macroscopically hard fibrous mass that is attached to the dura without calcification or caseation, and is situated deep in a sulcus in relation to the meninges. The hard fibrous mass is considered to be a likely source of diffuse meningitis and is the result of bacillemia that occurs during the development of the primary lesion or after primary progressive infection (5,6). Radiologic features of en plaque tuberculomas include appearing hyperdense on noncontrast CT scans, isointense to the brain on T1WI, and isointense to hypointense to the brain on T2WI with homogeneous post-contrast enhancement (6, 7).…”

Section: Discussionmentioning

confidence: 99%

“…The differing MR spectroscopy pattern and presence of perilesional edema are among the few points that help in differentiating it from meningiomas (5). Srikanteswara et al (6) reported that a follow-up MRI study performed 6 months after initiation of anti-tuberculosis therapy in 5 patients showed a disappearance of the lesion as well as of the meningeal enhancement. Alkan et al (8) reported a case of the en plaque tuberculomas of tentorium in a pregnant woman.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical manifestations of the en plaque tuberculomas are variable and nonspecific, including fever, headache, visual blurring, vomiting, neck tilt, focal seizures and limb weakness. These features depend on the location (6).…”

Section: Discussionmentioning

confidence: 99%

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En Plaque Tuberculoma: a Case Report

Kim

Lee

Hwang

et al. 2016

Investig Magn Reson Imaging

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In Korea, tuberculosis is still common disease. Central nervous system tuberculosis can manifest in a variety of forms, including tuberculous meningitis, tuberculous cerebritis, tuberculoma, tuberculous abscess, and miliary tuberculosis. Although intra-axial tuberculomas are the more common type of CNS tuberculosis, extraaxial lesions are rarely encountered. En plaque tuberculoma is an extremely rare presentation of intracranial tuberculosis with mimicking primary or secondary meningeal neoplasia. We describe a rare case of an en plaque tuberculoma accompanied by tuberculous meningitis and tuberculomas.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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En Plaque Tuberculoma: a Case Report

Kim

Lee

Hwang

et al. 2016

Investig Magn Reson Imaging

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“…One such parameter is location of the tuberculoma which can be intra-axial and extra-axial / meningeal based lesions. 18,19 Another parameter is the signal of the tuberculoma lesion on conventional MRI imaging based on which a tuberculoma can be classified as non-caseating, caseating granuloma with liquefied center and caseating granuloma with solid center. 20 Tuberculomas can also be differentiated into treated versus untreated types, however the most important differentiation which impacts the patient management and treatment strategy is the response of the tuberculoma to the standard anti tuberculous treatment.…”

Section: Discussionmentioning

confidence: 99%

MR textural features (RADIOMICS) for predicting response to treatment in patients with intracranial tuberculoma: A retrospective cross-sectional study

Awais¹,

Khan²,

Muhammad³

et al. 2023

PJNS

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Background and objective: MR based radiomics can potentially response to treatment in intracranial tuberculoma, but very scarce literature is available in this regard. The purpose of this study was to determine whether MR based radiomic features can be used to predict response to antituberculosis (AT) treatment. Methods: Data of patients with intracranial tuberculomas who underwent MR imaging and AT treatment at our institution during the last 10 years was analyzed. In each case follow-up imaging performed at 6 months post initiation of treatment was reviewed to establish response to treatment. The textural analysis was performed by two consultant neuroradiologists, using open-source software (Lifex) with FLAIR coronal image after contrast administration from pretreatment MRI study radiomic analysis. Results: Twenty-four patients with mean age 33.8 years were included in the study. Sixteen patients were in the treatment responsive group while eight patients were in the treatment resistant group. Thirty-eight radiomic parameters were extracted for each patient. There was a significant difference in three out of 38 parameters (histogram skewness, GLCM correlation and NGLDM Coarseness) in patients amongst the two groups. Logistic regression model was developed using these parameters which accurately predicted 83.3% of the cases according to the response to the AT treatment (χ2=11.517, p=0.003). ROC curve analysis was performed using histogram skewness which showed acceptable discrimination (p=0.037 and 95% CI =0.577-0.954) for predicting the response to treatment. Conclusion: MR textural parameters (histogram skewness, GLCM correlation and NGLDM Coarseness) may be used as imaging biomarkers to predict response to treatment in patients with intracranial tuberculoma.

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Giant central nervous system tuberculoma in pediatric patients: surgical case series

Xiao

2021

Childs Nerv Syst

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Central nervous system tuberculoma is rare and challenging situation. Clinical records of patients with pathologically proven tuberculoma were retrospectively reviewed. Clinical presentation, lesion location, radiological characteristics, perioperative and surgical management, and outcome is summarized and analyzed. Eight patients were included and there was one girl. Age ranged from 3 to 14 years with mean age 9.8 years. Clinical duration ranged from 20 days to 2 years, and 3 patients had previous lung tuberculosis with anti-TB treatment. The lesion was in cerebellum in 6 cases, including 1 involving basal ganglia and 1 involving thalamus. The lesion was in basal ganglia, thalamus, and third ventricle in 1 case, and in T12-L1 spinal cord in another. Cerebellar lesion was resected via paramedian suboccipital approach in 5 patients, basal ganglia lesion via trans-cortical frontal horn approach in 2 patients, and intra-spinal lesion via trans-laminar approach in 1 patient. Follow-up ranged from 10 to 24 months. Of the 8 patients, 6 returned to normal life. One patient had cerebellar lesion resected and the thalamic lesion reduced in size after anti-TB treatment. One patient died from TB spreading. Our data showed that most patients can be successfully treated by resection of the lesion. Low T2 signal, ring shaped enhancement and peripheral edema strongly suggest tuberculoma. Empirical anti-TB treatment should be initiated perioperatively.

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En-Plaque Central Nervous System Tuberculoma - An Uncommon Entity: Clinico-Radiological Profile in a Cohort from a Tertiary Referral Centre

Cited by 4 publications

References 12 publications

En Plaque Tuberculoma: a Case Report

En Plaque Tuberculoma: a Case Report

MR textural features (RADIOMICS) for predicting response to treatment in patients with intracranial tuberculoma: A retrospective cross-sectional study

Giant central nervous system tuberculoma in pediatric patients: surgical case series

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