• Internal medicine · Jun 2023

    Case Reports

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

    • Morihiro Yamamoto, Tatsuo Manabe, Kazuki Yokokawa, Kazufumi Tsuzaka, Minoru Yamada, Rei Miyanaga, Taro Saito, Daisuke Yamamoto, Akihiro Matsumura, Syuuichirou Suzuki, and Shin Hisahara.
    • Department of Neurology, School of Medicine, Sapporo Medical University, Japan.
    • Intern. Med. 2023 Jun 15; 62 (12): 182718331827-1833.

    AbstractA 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.

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