201
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Suzuki Y, Hasegawa H, Ushiyama E, Inomata A, Satoh H, Ogino S, Ohnish Y, Arakawa M. [A case of nephrotic syndrome with membranous nephropathy and renal tuberculous granuloma]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 1989; 78:1181-6. [PMID: 2809389 DOI: 10.2169/naika.78.1181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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202
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Fujieda K, Ito T, Okubo S, Morinari H, Harasawa M, Masuda S, Yakumaru K. [A case of localized pleural tuberculosis exacerbated during antituberculous chemotherapy]. KEKKAKU : [TUBERCULOSIS] 1989; 64:367-72. [PMID: 2796109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A 24 year-old male with pulmonary tuberculosis in right upper lobe developed two lesions of extrapulmonary pleural tuberculoma during the course of antituberculous therapy. He had no history of lung tuberculosis nor pleurisy. However, the chest X-ray film on first admission showed scattered nodular shadows in right upper lung field. He had no subjective symptoms and no abnormalities of laboratory findings except mild iron deficiency anemia, from which he recovered completely without specific therapy. Three months after starting the antituberculous therapy including SM, INH, and RFP, a new round homogeneous opacity appeared in the right lower lung field (S4). Chest CT scan revealed the lesions in S10 as well as in S4. Microscopic examination of the specimen obtained by ultrasound-guided needle aspiration biopsy disclosed positive acid-fast bacilli. Because of the lack of effect of drug therapy on pleural lesions, surgical treatment was performed. The visceral pleura was found adherent fibrously to parietal pleura, which was easily separated by hand. However, at the site of lesions, the adhesion was so tight that extrapleural resection was needed. Because lung tissue and tumor were connected tightly, the lung had to be partially resected. Most content of tumors were caseous necrosis. Although main lesion was located outside of the lung, intrapulmonary invasion was also noticed. Double lesions of this kind of disease seem to be very rare. There is no evidence of relapse until eight months after surgery.
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203
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Yokoyama T, Komurasaki Y, Asano T, Ogura J, Maeda K. [A case of tuberculous encephalopathy with multiple intracranial tuberculomas]. Rinsho Shinkeigaku 1989; 29:622-5. [PMID: 2791413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A case of 56-year-old man with tuberculous encephalopathy following pulmonary tuberculosis was reported. Computed tomography (CT) revealed low density virtually confined to the white matter of the cerebral hemisphere. Contrast enhanced CT demonstrated intracranial multiple spotted lesions, all of which were homogeneously enhanced, supporting multiple intracranial tuberculomas. Magnetic resonance miss spelling imaging (MRI) suggested brain edema and demyelination of the white matter. Clinically this case was characterised by evidence of diffuse cerebral involvement in the form of convulsions, abnormal behavior and consciousness impairment without significant signs of meningitis. Antituberculous chemotherapy improved both clinical symptoms and intracranial lesions on CT and MRI. These findings strongly suggested the diagnosis of tuberculous encephalopathy with multiple tuberculomas. No adult case of tuberculous encephalopathy with multiple intracranial tuberculomas has been previously reported.
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204
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Ma K. [An X-ray-pathologic correlation of the lung-nodule interface in peripheral lung cancer vs. pulmonary tuberculoma]. ZHONGHUA YI XUE ZA ZHI 1988; 68:682-4, 48. [PMID: 3248249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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205
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Abstract
MR imaging was performed on 27 children with stage II-III tuberculous meningitis for the specific purpose of examining the brainstem, as well as comparison with other CT features of the disease. In addition to defining the ischemic disturbances of basal ganglia and diencephalon more clearly, MR also demonstrates the frequent occurrence of parenchymal signal abnormalities in the brainstem and adjacent temporal lobes, which are invisible or uncertain on CT. Although the presence of brainstem abnormalities on MR correlated well with clinical findings of brainstem dysfunction, clinical staging on admission remains the best prognostic indicator in advanced TBM. We also review the MR features of basal exudation, hydrocephalus and tuberculoma.
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206
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Delsedime M, Aguggia M, Cantello R, Chiado Cutin I, Nicola G, Torta R, Gilli M. Isolated hypophyseal tuberculoma: case report. Clin Neuropathol 1988; 7:311-3. [PMID: 3224474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
A 45-year-old woman, lifelong resident in Turin presented an isolated tuberculous granuloma of the hypophysis with no other systemic localizations. Diagnosis could be established only by biopsy. With antituberculous therapy the intracellular tumor regressed but not the endocrine disorders.
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207
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Zakharova GP, Gusev GA. [Tuberculoma of the choroid simulating an intraocular tumor]. Vestn Oftalmol 1988; 104:69-71. [PMID: 3242213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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208
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Divate PG, Apte CA. Focal epilepsy in India. J Neurol Neurosurg Psychiatry 1988; 51:1365-6. [PMID: 3147316 PMCID: PMC1032935 DOI: 10.1136/jnnp.51.10.1365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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209
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O'Brien NC, van Eys J, Baram TZ, Starke JR. Intracranial tuberculoma in children: a new look at an old problem. South Med J 1988; 81:1239-44. [PMID: 3051426 DOI: 10.1097/00007611-198810000-00010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Intracranial tuberculoma has become a rare cause of space-occupying intracranial lesions in childhood, but it must still be considered in the differential diagnosis. Tuberculosis remains a significant disease in developing countries and in the United States, and tuberculoma is a well known presentation of childhood tuberculosis. This diagnosis must be considered especially in persons traveling or living in developing countries and in immigrants from third-world areas. We report three cases of tuberculoma in children seen during one year at our institutions to illustrate the need for continued suspicion. We summarize the clinical presentation and current treatment recommendations and review the available literature.
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210
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Ruch-Trinkle J, Mehdorn HM, Reinhardt V, Pospiech J. [Tuberculoma of the posterior fossa with symptoms of a cerebellopontile angle tumor. Case report and review of the literature]. NEUROCHIRURGIA 1988; 31 Suppl 1:199-201. [PMID: 3068565 DOI: 10.1055/s-2008-1053935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The case of a 54-year old woman is reported to discuss problems to establish preoperatively the correct diagnosis of tuberculoma in the posterior fossa. Following surgical excision of the space-occupying lesion, antituberculotic therapy was initiated. Complete recovery was achieved.
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211
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Pittella JE, Toppa NH. [Multiple cerebral tuberculomas: report of an autopsy case with 37 lesions]. ARQUIVOS DE NEURO-PSIQUIATRIA 1988; 46:176-81. [PMID: 3202715 DOI: 10.1590/s0004-282x1988000200008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
An autopsied case of multiple cerebral tuberculomas with 37 lesions, the one with the greatest number of lesions described in the literature, is reported. The patient was a chronic alcoholic and had generalized tuberculosis. The literature on multiple cerebral tuberculomas is reviewed and the neurological clinical picture presented by the patient and the association between generalized tuberculosis and chronic alcoholism are commented upon.
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212
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Nucci F, Mastronardi L, Artico M, Ferrante L, Acqui M. Tuberculoma of the ulnar nerve: case report. Neurosurgery 1988; 22:906-7. [PMID: 2837676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A peripheral nerve tuberculoma, the third on record, involved the ulnar nerve, as did the other two. This case report is followed by a discussion of the pathogenesis and diagnosis of this lesion. Its pathogenesis is unclear. Direct infection from a tuberculous sister was disproved, and infection via a local wound is highly unlikely. A previous, silent form of tuberculosis seems to have been the cause.
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213
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Abstract
Tuberculomas of the brain can now be diagnosed readily with computerised axial tomography. A rare, biopsy proven case of a third ventricular tuberculoma is presented. Typical CT scan findings are discussed and management with drugs and minimal surgical intervention when necessary is stressed.
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214
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Mathuriya SN, Khosla VK, Banerjee AK. Intradural extramedullary tuberculous spinal granulomas. Clin Neurol Neurosurg 1988; 90:155-8. [PMID: 3208471 DOI: 10.1016/s0303-8467(88)80038-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Four cases of intradural extramedullary tuberculous spinal granulomas without bony involvement are presented. Both, the rarity of the disease, as well as the successful microsurgical resection with good recovery prompted this report. The pathogenesis with the controversies therein, is discussed and pertinent literature is reviewed.
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215
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Morimoto T, Sasaki T, Basugi N, Nagayama I, Umemura H. [Tuberculoma and tuberculous meningitis mimicking metastatic brain tumor and meningeal carcinomatosis--case report]. NO SHINKEI GEKA. NEUROLOGICAL SURGERY 1987; 15:1345-50. [PMID: 3448503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A 45-year-old man was well until February 1986, when he experienced gait disturbance and psychiatric symptoms. On February 11 he fell down several times and developed generalized convulsion on the following day. He was admitted to a hospital in a delirious condition. The chest X-ray film showed infiltration in the left upper lobe, but computed tomographic (CT) scan of the head revealed no abnormality. Cerebrospinal fluid obtained by lumbar puncture contained 155 cells/mm3, all of which were lymphocytes, and protein and glucose concentrations were 372 mg/dl and 68 mg/dl respectively. In spite of negative smear tests of sputum and cerebrospinal fluid for tubercle bacilli he was administered antituberculosis drugs on the suspicion of pulmonary tuberculosis and tuberculous meningitis. His level of consciousness gradually returned to normal but the follow-up CT scans showed a low density area with contrast enhancement in the right thalamus and obliteration of the right quadrigeminal cistern which was also enhanced with contrast medium. He was transferred to our hospital on March 28 for further evaluation. On admission to our hospital he was alert and oriented, his pupils were equal and reactive to light and he had mild left hemiparesis, left hyperreflexia and left hemihypesthesia. Cell count of the cerebrospinal fluid was 243/mm3, 90% of which were lymphocytes and protein and glucose contents were 340 mg/dl and 42 mg/dl respectively. Both smear and culture of the cerebrospinal fluid were negative for tubercle bacilli and other organisms. Cytological examination of the cerebrospinal fluid demonstrated clusters of cells of various sizes with high N/C ratio which suggested these cells were malignant.(ABSTRACT TRUNCATED AT 250 WORDS)
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216
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Abstract
We report a unique case of exclusively intrasellar tuberculoma. The patient was operated on by the transsphenoidal approach, which allowed total removal of the lesion and prevented cerebrospinal fluid contamination. After histological diagnosis, the patient was treated with isoniazid, 300 mg daily for 3 months, as prophylaxis against tuberculous meningitis.
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217
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Albu A, Cîrciumărescu C. [Solitary pulmonary nodule]. REVISTA DE IGIENA, BACTERIOLOGIE, VIRUSOLOGIE, PARAZITOLOGIE, EPIDEMIOLOGIE, PNEUMOFTIZIOLOGIE. PNEUMOFTIZIOLOGIA 1987; 36:337-46. [PMID: 2838885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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218
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Abstract
Experience with fifteen consecutive cases of intracranial tuberculomas, treated between 1981 and 1986, is summarized. Histological confirmation was obtained in twelve patients, and acid fast bacilli (AFB) were found in and cultured from the excised lesions and biopsy specimens in nine patients. Difficulties in diagnosis are discussed. A plan of management combining the operative treatment and medical therapy of the tuberculomas is outlined. The value of computerized tomography in the diagnosis and management of these patients is emphasized.
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219
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Angiari P, Corradini L, Crisi G, Botticelli A, Merli GA. [Cerebral tuberculoma. Clinical case]. RIVISTA DI NEUROLOGIA 1987; 57:281-4. [PMID: 3445069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The authors report of a patients operated for a double encephalic mass in the left posterior parietal region. This lesion resulted a tubercoloma at a later investigation. This pathology is relatively common in underdeveloped countries, declining in western countries. The authors emphasize the need of a careful evaluation in searching tuberculous infection in presence of encephalic granulomatous masses.
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220
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Li TY. [Analysis of 1917 radiologico-pathological correlated operated cases of respiratory diseases]. ZHONGHUA FANG SHE XUE ZA ZHI CHINESE JOURNAL OF RADIOLOGY 1987; 21:196-201. [PMID: 2961534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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221
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Gaultier Y, Alou A, Cénac A, Develoux M, Vetter JM. [Tuberculoma of the heart. Contribution of echography. Apropos of a case]. ARCHIVES DES MALADIES DU COEUR ET DES VAISSEAUX 1987; 80:1413-6. [PMID: 3122692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
An 18-year old woman was admitted to hospital with signs of right heart failure and atrial tachycardia. Ultrasounds showed a tumoral mass in the tricuspid valve. Post-mortem examination revealed that the mass was a tuberculoma obstructing the tricuspid orifice. The exceptional character of this case is emphasized: lesions of the heart have been found in less than 0.3 p. 100 of tuberculous patients autopsied. The different anatomical aspects of tuberculosis of the heart are mentioned, and it is suggested that echocardiography should be performed systematically in all patients with severe, disseminated tuberculosis. Tuberculoma of the heart should figure on the list of intraparietal and intraluminal masses visualized at echocardiography.
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222
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Wakisaka S, Soejima T, Matsuoka S. Cerebellar tuberculoma--a case report and review of the literature. Neurol Med Chir (Tokyo) 1987; 27:31-6. [PMID: 2441285 DOI: 10.2176/nmc.27.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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223
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Venger BH, Dion FM, Rouah E, Handel SF. MR imaging of pontine tuberculoma. AJNR Am J Neuroradiol 1987; 8:1149-50. [PMID: 3120549 PMCID: PMC8332343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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224
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Dastur DK, Dave UP. Fine structure of cellular and vascular reaction in brain tuberculomas: a model for phagocytosis in the CNS. Pathol Res Pract 1986; 181:721-32. [PMID: 3562342 DOI: 10.1016/s0344-0338(86)80048-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The fine structure of cells of the mononuclear phagocyte series (MPS) and a few other cells with phagocytic capacity, has been critically evaluated, mainly from an electronmicroscopic examination of the reactive border zone of 11 human brain tuberculomas, which provide ideal material for the study of macrophages. Most of them appeared to be blood monocyte-derived epithelioid cells of various forms and stages. The cytoplasm of these cells showed either more rough ER representing protein synthesising activity; or more frequently, phagosomes, phagolysosomes, dense bodies or empty vacuoles, representing various stages of ingestion and digestion of necrotic material. Often such material, which was more or less osmiophilic, was seen abundantly between the cells. These actively phagocytic cells occasionally undergoing, mitosis, are referred to as "epithelioid macrophages" and were morphologically similar to the "activated microglia" described in other conditions. They also showed a tendency to be closely adjacent to each other and occasionally fuse to form giant cells. There were also a number of lymphocytes and plasma cells. The latter showed various stages of active and granular or depleted and distended rough ER tubules, phagocytic activity and tendency to fuse. Expected vasculitis and small vessel necrosis formed part of this granulomatous reaction. Constituents of oedematous or necrosed brain tissue were seen immediately around the reactive zone of these tuberculomas, the most frequent being reactive astrocytes, many of which showed membrane-bound vacuoles. It is conceivable that the excessive pleomorphic cellular, vascular and necrotic reaction in these brain tuberculomas could have resulted from a delayed type of hypersensitivity to a very small quentity of antigenic tuberculoprotein, which probably initiates the chain of immunologic responses.
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225
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Vodoz JF. [Transthoracic pulmonary needle puncture. Apropos of 21 cases]. REVUE MEDICALE DE LA SUISSE ROMANDE 1986; 106:827-31. [PMID: 3775166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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226
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Ayanru JO, Alli AF, Faal HB, Elebesunu MI, Sykes RM. Tuberculoma of the eye; a case report. TROPICAL AND GEOGRAPHICAL MEDICINE 1986; 38:301-4. [PMID: 3750400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A case of tuberculoma of the eye is reported occurring in a 3-year-old girl. Clinically presenting as a case of leucocoria a pre-operative diagnosis of retinoblastoma was made, necessitating enucleation of the eye. Post-operatively a diagnosis of intraocular tuberculosis was made. The differential diagnosis is discussed and the importance of inclusion of intraocular tuberculoma in the differential diagnosis of retinoblastoma is stressed.
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227
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Abstract
Tuberculous meningitis is a rare, treatable neurologic disorder, in which early recognition is paramount because outcome depends greatly on the speed with which therapy is initiated. Patients with meningitis and CSF findings of low glucose, elevated protein and pleocytosis with evidence of tuberculosis elsewhere in the body (chest radiographs, positive tuberculin skin test), or a history of exposure to tuberculosis should be treated immediately with antituberculous medication. When the diagnosis remains uncertain, serial examination of the CSF for tuberculous organisms will often yield positive results. The CT scan may show hydrocephalus, a basilar arachnoiditis, or intraparenchymal lesions: tuberculomas. Hydrocephalus may respond to early shunting. Tuberculomas are best treated medically. Therapy should include INH and rifampin; ethambutol and pyrazinamide are suggested for the first 2 months of therapy. Steroids may be useful in diminishing the inflammatory response when altered consciousness or focal neurologic signs are present.
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228
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Rodríguez-Carbajal J, Torres-Morán L, León-Tosi P, Muñoz-Rivera C, Escobar-Izquierdo A. [Cerebral tuberculoma. Clinical and radiographic study of 31 cases]. GAC MED MEX 1986; 122:205-12. [PMID: 3596131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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229
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Benov E. [Transthoracic fine-needle aspiration biopsy in the diagnosis of tuberculoma]. REVISTA DE IGIENA, BACTERIOLOGIE, VIRUSOLOGIE, PARAZITOLOGIE, EPIDEMIOLOGIE, PNEUMOFTIZIOLOGIE. PNEUMOFTIZIOLOGIA 1986; 35:271-2. [PMID: 3027866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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230
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Renner F, Karnel F, Graninger W, Imhof H. [Addison's disease with enlarged adrenal glands in sonography and computer tomography. Differential diagnostic considerations based on 2 cases of tuberculous adrenalitis]. Wien Klin Wochenschr 1986; 98:244-9. [PMID: 3521105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
One of the major causes of chronic adrenal insufficiency (Addison's disease) is tuberculous adrenalopathy. Since sonography and computed tomography have become generally available in recent years and are of potential help in the diagnosis of this disease the merits of these methods are discussed in the light of 2 cases of adrenal tuberculosis, followed by a review of the literature. Adrenal calcification is the most significant, although not specific sign of adrenal insufficiency due to tuberculosis. Computed tomography has proven to be the method of choice in the non-invasive diagnosis of tuberculous adrenalopathy and in the monitoring of tuberculostatic treatment in this disease. Sonography is helpful as a preliminary investigation.
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231
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Barcikowski S, Leksowski K, Sapiezko J, Kozak J. [Benign lung tumors]. PNEUMONOLOGIA POLSKA 1986; 54:148-52. [PMID: 3737432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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232
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Lepori JC, Almeras M, Plenat F, Lesure P. [Pseudotumoral tuberculoma of the orbit]. BULLETIN DES SOCIETES D'OPHTALMOLOGIE DE FRANCE 1986; 86:339-42. [PMID: 3802346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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233
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Kunishio K, Sunami N, Yamamoto Y, Asari S, Akagi T, Ohtsuki Y. [Cystic cerebral tuberculoma--a case report]. NO SHINKEI GEKA. NEUROLOGICAL SURGERY 1986; 14:429-34. [PMID: 3703146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A case of cystic cerebral tuberculoma is presented. A 63-year-old man was admitted initially to a sanatorium in May, 1983, for the treatment of pulmonary tuberculosis. He developed headache and vomiting, and suddenly had a right hemiconvulsion on September 27, 1983. Gradually he developed right hemiparesis and motor aphasia. CT scan revealed a well defined, ring-like enhanced mass with multiloculated cysts in the left fronto-parietal lobe. So, he was transferred to our hospital on February 3, 1984. Neurological examination revealed that he had motor aphasia and right hemiparesis. Left carotid angiogram showed light tumor stain in the left fronto-parietal lobe, and 99mTc brain scan detected increased uptake in this area. A left fronto-parieto-temporal craniotomy was performed and a subcortical mass was excised en bloc. The mass had multiloculated cysts containing xanthochromic fluid. Histologically, the mass was cystic cerebral tuberculoma. Cystic cerebral tuberculomas have rarely been reported even before the introduction of antituberculous chemotherapy. The pathogenesis of the cysts in this particular case was considered that the caseous material would have undergone liquefaction by enzymes liberated from degenerated and fragmented inflammatory cells.
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234
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Abstract
Two cases of tuberculosis of the jaws, one of tuberculous osteomyelitis and one of tuberculous granuloma, are presented. These lesions were the only manifestations of the disease in the patients, and the possibility that they were primary lesions is discussed. Although tuberculosis rarely affects the jaws, it should be considered in the differential diagnosis, since this disease, continues to be a health problem in both developed and underdeveloped countries.
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235
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Arai T, Hirata M, Kimura S, Inagaki K, Kadokura M, Shinada J, Hayashi Y, Suzuki T, Otani N, Nakano A. [Analysis of pulmonary tuberculomas diagnosed by exploratory excision]. KEKKAKU : [TUBERCULOSIS] 1986; 61:1-7. [PMID: 3086609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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236
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Bork K. [Disseminated lichenoid form of lupus vulgaris]. DER HAUTARZT 1985; 36:694-6. [PMID: 4086300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The disseminated forms of skin tuberculosis are extremely uncommon and can occur as acute miliary tuberculosis with skin involvement, which is a severe disease with a rapid course, or as slowly developing lupus vulgaris, i.e., "postexanthematic lupus vulgaris" or "lupus vulgaris disseminatus". A 61-year-old female patient developed unusual lichenoid brownish lesions caused by disseminated lupus vulgaris, which were confined to the right leg. The patient had no other signs of tuberculosis.
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237
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Yamamoto N, Kadoya S, Nakamura T, Emori T, Kwak R, Hirose G. [A case report of intracerebral tuberculoma during antituberculous therapy]. NO SHINKEI GEKA. NEUROLOGICAL SURGERY 1985; 13:1007-11. [PMID: 4069312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A case of multiple intracerebral tuberculoma occurred in the course of anti-tuberculous therapy is reported. A 16-year-old high school boy had been treated with isoniagid, streptomycin and paramino-salicylic acid on the tuberculous pleulitis for 3 months previously. He was admitted to our hospital because of progressive headache associated with vomiting. Neurological examination revealed bilateral full papilledema and incomplete bilateral abducens palsy. An immediate CT study with contrast enhancement demonstrated two small ring-like mass with considerable perifocal edema in the left temporal and occipital lobe, respectively. Intracerebral tuberculoma was considered to be most likely, so the patient was given antituberculous therapy with steroid and mannitol. However, despite of medical decompression, he developed intracranial hypertension aggravated, leading to removal of tumor 7 days after admission. Initially left temporal tuberculoma, which had more extensive and prominent perifocal edema, was successfully excised. The specimen was a walnut-sized granuloma with hard capsule including pus inside. Numerous tuberculous bacilli were identified with Ziel-Nielsen staining technique from the pus. Postoperative course was gratifying, and other tumor in the left occipital lobe, which was also diagnosed as tuberculoma, was treated with continuing administration of isoniagid, ethanbutol and rifampicin. However, the former two drugs were forced to be discontinued because of agranulocytosis. Only rifampicin was maintained for 2 months thereafter but no decrease of the size was observed in serial CT studies. Then left occipital tuberculoma was removed. The pathology was tuberculoma with positive bacilli staining. He discharged 1 month later without any neurological deficit but was on antituberculous therapy (rifampisin) as an outpatient for 3 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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238
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Danesi MA, Arigbabu SO, Mordi PN, Ojikutu NA. Intracranial tuberculoma in Lagos, Nigeria. TROPICAL AND GEOGRAPHICAL MEDICINE 1985; 37:279-80. [PMID: 4071653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Two cases of intracranial tuberculoma treated by us and histologically proven at the Lagos University Teaching Hospital are reported. Both cases had a supratentorial lesion and had no extracranial tuberculosis. Tuberculoma appears to be relatively uncommon in Nigeria. There are some differences in the clinical picture in Nigerian cases compared to others reported.
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239
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Lyon CE, Grimson BS, Peiffer RL, Merritt JC. Clinicopathological correlation of a solitary choroidal tuberculoma. Ophthalmology 1985; 92:845-50. [PMID: 3897938 DOI: 10.1016/s0161-6420(85)33964-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
In a 34-year-old black man with pulmonary tuberculosis, a rapidly enlarging choroidal tuberculoma progressed to larger size, despite appropriate systemic anti-tuberculous therapy. The eye harboring the tuberculoma became blind and painful, and was subsequently enucleated. Conventional staining of tissue sections revealed a choroidal granuloma without evidence of organisms, but tubercle bacilli were demonstrated by fluorescence microscopy.
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240
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Garcia Allut A, Gelabert González M, Bollar Zabala A, Martinez Rumbo R, Reyes Santias R. Intradural extramedullar tuberculoma of spinal cord. Case report. J Neurosurg Sci 1985; 29:113-5. [PMID: 4093798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A case of intradural tuberculoma in an infant and the patient was diagnosed operated on successfully. The author's advice is to perform surgery followed by antituberculosis treatment during the recovery period.
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241
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Goldberg I, Avidor I. Isolated tuberculous tenosynovitis of the Achilles tendon. A case report. Clin Orthop Relat Res 1985:185-8. [PMID: 3978914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The diagnosis of isolated tuberculosis of the Achilles tendon was made in a 50-year-old man by excision of the lesion and histologic examination. The patient was free of other systemic symptoms or other foci of infection. The wound healed without complication with the aid of antituberculous chemotherapy. The lesion recurred after nine years, at which time it was again excised and the diagnosis confirmed. Eight years later, the patient remains symptom-free with no signs of recurrence.
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242
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Monteiro ML, Coppeto JR. Cryptic disseminated tuberculosis presenting as gaze palsy. JOURNAL OF CLINICAL NEURO-OPHTHALMOLOGY 1985; 5:27-9. [PMID: 3156884 DOI: 10.3109/01658108509071456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We present a case of gaze palsy caused by a pontine tuberculoma associated with cryptic disseminated tuberculosis. The only symptoms in this patient were those caused by her gaze abnormality despite the presence of disseminated tuberculosis that was later confirmed at autopsy.
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243
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Piszczor M, Thornton G, Bia FJ. The evaluation of contrast-enhancing brain lesions: pitfalls in current practice. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 1985; 58:19-27. [PMID: 4013370 PMCID: PMC2589829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The definitive diagnosis of space-occupying brain lesions can be established more readily since the advent of computerized tomographic (CT) scanning. Some brain lesions are more clearly defined when contrast-enhancing agents are utilized; however, so-called ring-enhancing lesions are not pathognomonic for specific neurological entities. Review of the literature suggests that at least four disorders must be considered in the differential diagnosis of contrast-enhancing lesions. These include mature brain abscesses of any etiology, cerebrovascular accidents, and primary or metastatic brain tumors. Since the medical and surgical management of these conditions is quite different, it is critical to establish a diagnosis before therapy is instituted. In many instances the combination of history, physical examination, laboratory, and radiologic examination will enable physicians to correctly diagnose the etiology of such brain lesions. However, we present two cases for which the above clinical and non-invasive parameters led to incorrect working diagnoses. Brain biopsy was required before appropriate management was eventually instituted. Potentially, such delays in diagnosis and institution of therapy can result in unnecessary morbidity and mortality. Each case illustrates the need to substantiate a presumptive diagnosis based on these clinical and radiographic criteria, regardless of how "typical" lesions may appear on CT scans.
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244
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Saito A, Kuwana N, Mochimatsu Y, Tanaka N, Tokoro K. [Multiple cerebral tuberculomas. Case report]. Neurol Med Chir (Tokyo) 1984; 24:958-62. [PMID: 6085144 DOI: 10.2176/nmc.24.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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245
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Sagara K, Fujiyama S, Umeda T, Sato T, Tashiro S, Miyayama H. Hepatic granuloma. Report of a case successfully treated by hepatectomy and antituberculous therapy. GASTROENTEROLOGIA JAPONICA 1984; 19:556-62. [PMID: 6526255 DOI: 10.1007/bf02793870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A 62 year-old male presented with high fever, weight loss and painful hepatomegaly. The clinical presentation, results of laboratory studies, angiography and laparotomy suggested hepatic abscess or cholangiocarcinoma. He underwent left lobe hepatectomy, and pathological examinations revealed granuloma. Acid-fast bacilli, fungi and parasites were not identified by special stainings. Hepatic tuberculosis was considered most likely because, after operation, an intermediate-strength purified protein derivative (PPD) skin test gave strongly positive results and his subsequent response to antituberculous treatment was excellent. His complex clinical features and the diagnostic difficulties were outlined.
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246
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Paradoxical expansion of intracranial tuberculomas during chemotherapy. Lancet 1984; 2:749-50. [PMID: 6148497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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247
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Williams WJ. All that glitters is not sarcoidosis. SARCOIDOSIS 1984; 1:16-23. [PMID: 6400573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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248
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Paradoxical expansion of intracranial tuberculomas during chemotherapy. Lancet 1984; 2:470-1. [PMID: 6147541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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249
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Li TY. [Roentgen diagnosis of pulmonary hamartoma]. ZHONGHUA JIE HE HE HU XI XI JI BING ZA ZHI = CHINESE JOURNAL OF TUBERCULOSIS AND RESPIRATORY DISEASES 1984; 7:224-6, 254. [PMID: 6543773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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250
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Chambers ST, Hendrickse WA, Record C, Rudge P, Smith H. Paradoxical expansion of intracranial tuberculomas during chemotherapy. Lancet 1984; 2:181-4. [PMID: 6146749 DOI: 10.1016/s0140-6736(84)90478-1] [Citation(s) in RCA: 141] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
4 patients with tuberculosis, 3 of whom had tuberculous meningitis, were noted to have tuberculomas on computed tomographic scanning. During antituberculous chemotherapy the intracranial lesions increased in size in all 4 patients at a time when the clinical state and cerebrospinal-fluid abnormalities were improving; in 2 of the patients the regional lymph nodes also enlarged greatly. Though the expansion of the cerebral lesions caused anxiety and led to some changes in chemotherapy, the lesions eventually diminished in size.
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