Two autopsy cases of multiple cerebral tuberculomas

Abstract

Two cases of multiple cerebral tuberculomas are described. A 59‐year‐old female had liver cirrhosis and was suspected of having metastatic tumors in the brain. A 65‐year‐old female had chronic renal failure and was diagnosed with miliary tuberculosis and treated with antituberculous drugs. In both cases, consciousness became disturbed gradually. Both patients were diagnosed with multiple cerebral tuberculomas after death. Histologically, both cases showed cerebral granulomas comprising epithelioid cells mixed with reactive astrocytes, and fibrous gliosis surrounding a core of caseous necrosis. These lesions were readily detected by Holzer staining. Some blood vessels around the granulomas showed vasculitis with lymphocyte infiltration in the walls and obliteration of the lumina by epithelioid cell proliferation. In this report, the unique histological features of the multiple cerebral tuberculoma are described and it is suggested that the obliterative vasculitis around them may have caused the disturbed consciousness.