Tuberculomas

Tuberculomas or tuberculous granulomas are well defined focal masses that result from Mycobacterium tuberculosis infection and are one of the more severe morphological forms of tuberculosis. Tuberculomas most commonly occur in the brain (see: CNS tuberculosis) and the lung (see: pulmonary tuberculosis).

Terminology

Tuberculomas should not be confused with the far less common tuberculous abscess.

Pathology

Macroscopic appearance

Macroscopically, a tuberculoma is a well defined firm nodule with central caseous necrotic center .

Microscopic appearance

Histologically it consists of a central core of caseating necrosis with a surrounding wall of a florid granulomatous reaction containing Langhans giant cells, epithelioid histiocytes and lymphocytes. Unlike tuberculous abscesses, organisms are uncommon or absent, and acute inflammatory infiltrate is not a prominent feature.

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