Cerebral Tuberculoma Diagnosed by Nested Polymerase Chain Reaction of a Formalin-fixed Paraffin-embedded Brain Biopsy Sample

A 38-year-old man was taken to hospital with generalized clonic seizure. Brain magnetic resonance imaging (MRI) showed multiple ring-enhancing lesions centered in the left frontoparietal lobe. A histopathological examination of a brain biopsy sample revealed granulomatous lesions with caseous necros...

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Bibliographic Details
Published in:Internal Medicine 2023/06/15, Vol.62(12), pp.1827-1833
Main Authors: Yamamoto, Morihiro, Manabe, Tatsuo, Yokokawa, Kazuki, Tsuzaka, Kazufumi, Yamada, Minoru, Miyanaga, Rei, Saito, Taro, Yamamoto, Daisuke, Matsumura, Akihiro, Suzuki, Syuuichirou, Hisahara, Shin
Format: Article
Language:English
Subjects:
Adult
Biopsy
Brain - diagnostic imaging
brain biopsy
Case Report
cerebral tuberculoma
DNA, Bacterial - analysis
DNA, Bacterial - genetics
Formaldehyde
formalin-fixed paraffin-embedded tissue
Genetic screening
Humans
Internal medicine
Lesions
Magnetic resonance imaging
Male
Mycobacterium tuberculosis - genetics
Neuroimaging
Nucleotide sequence
Paraffin
Paraffin Embedding
Polymerase chain reaction
Polymerase Chain Reaction - methods
Seizures
Sensitivity and Specificity
Tuberculoma
Tuberculosis
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Summary:A 38-year-old man was taken to hospital with generalized clonic seizure. Brain magnetic resonance imaging (MRI) showed multiple ring-enhancing lesions centered in the left frontoparietal lobe. A histopathological examination of a brain biopsy sample revealed granulomatous lesions with caseous necrosis. We extracted DNA from a formalin-fixed paraffin-embedded (FFPE) brain specimen, and nested polymerase chain reaction (PCR) of the DNA sample detected the Mycobacterium tuberculosis-specific insertion sequence IS6110. The lesions worsened after anti-tuberculosis drugs were administered, which we considered to be a paradoxical response and continued treatment. A genetic diagnosis of M. tuberculosis using FFPE specimens is useful for diagnosing tuberculoma.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.0356-22