Öz
Tuberculosis is an important pathological entity in developing countries with increased incidence. Non-osseous spinal cord tuberculomas can be found as extradural, intradural extramedullary, or intramedullary lesions. It has been estimated that intradural spinal tuberculomas comprise only 2–5% of central nervous system tuberculomas. A 31-year-old woman presented with a 2-month history of progressive paraparesis. Magnetic resonance imaging revealed an intradural, extramedullary lesion at L3-S2 levels with high contrast enhancement. Following operation, pathological examination of the lesion revealed granulomas with multinucleated and Langhans-type giant cells, and caseation necrosis typical of a tuberculoma. In the differential diagnosis of cauda equina lesions, primary intradural extramedullary tuberculomas should be considered as a rare entity
Anahtar Kelimeler
Kaynakça
- Mirzai H. Tuberculoma of the cervical spinal canal mimicking en plaque meningioma. J Spinal Disord Tech 2005;18:197–9.
- Shim DM, Oh SK, Kim TK, Chae SU. Intradural extramedullary tuberculoma mimicking en plaque meningioma. Clin Orthop Surg 2010;2:260–3. https://doi.org/10.4055/cios.2010.2.4.260
- Skendros P, Kamaria F, Kontopoulos V, Tsitouridis I, Sidiropoulos L. Intradural, extramedullary tuberculoma of the spinal cord as a complication of tuberculous meningitis. Infection 2003;31:115–7. https://doi.org/10.1007/s15010-002-3019-8
- Garg RK. Tuberculosis of the central nervous system. Postgrad Med J 1999;75:133–40.
- Rao GP. Spinal intramedullary tuberculous lesion: medical management. Report of four cases. J Neurosurg 2000;93:137–41.
- Sureka J, Samuel S, Keshava SN, Venkatesh K, Sundararaj GD. MRI in patients with tuberculous spondylitis presenting as vertebra plana: a retrospective analysis and review of literature. Clin Radiol 2013;68:e36–42. https://doi.org/10.1016/j.crad.2012.09.004
- Dastur HM. Diagnosis and neurosurgical treatment of tuberculosis disease of the CNS. Neurosurg Rev 1983;6:111–7.
- Konar SK, Rao KN, Mahadevan A, Devi BI. Tuberculous lumbar arachnoiditis mimicking conus cauda tumor: A case report and review of literature. J Neurosci Rural Pract 2011;2:93–6. https://doi. org/10.4103/0976-3147.80098
- Citow JS, Ammirati M. Intramedullary tuberculoma of the spinal cord: case report. Neurosurgery 1994;35:327–30.
Öz
Tüberküloz gelişmekte olan ülkelerde artmış sıklıkta görülen önemli bir patolojik hastalıktır. Kemik yerleşimi dışı tüberküloz vakaları, ekstradural, intradural ekstramedüller ya da intramedüller lezyonlardır. İntradural spinal tüberküloz vakalarının, santral sinir sitemi vakalarının yalnızca %2–5’ini oluşturduğu tahmin edilmektedir. Otuz bir yaşında bayan hasta, iki aydır ilerleyici paraparezi tanısı ile başvurdu. MRG incelemesinde, L3-S2 seviyeleri arasında kontrast tutan intradural ekstramedüller lezyon tespit edildi. Cerrahi sonrası lezyonun patolojik incelemesi, kazeifikasyon nekrozu ve Langerhans hücrelerinin eşlik ettiği multilobüle granülamöz reaksiyon olan tipik tüberkülom ile uyumlu idi. Ayırıcı tanıda, cauda equina lezyonlarının olduğu nadir görülen primer intradural ekstramedüller tüberküloz vakası tartışıldı
Anahtar Kelimeler
Kaynakça
- Mirzai H. Tuberculoma of the cervical spinal canal mimicking en plaque meningioma. J Spinal Disord Tech 2005;18:197–9.
- Shim DM, Oh SK, Kim TK, Chae SU. Intradural extramedullary tuberculoma mimicking en plaque meningioma. Clin Orthop Surg 2010;2:260–3. https://doi.org/10.4055/cios.2010.2.4.260
- Skendros P, Kamaria F, Kontopoulos V, Tsitouridis I, Sidiropoulos L. Intradural, extramedullary tuberculoma of the spinal cord as a complication of tuberculous meningitis. Infection 2003;31:115–7. https://doi.org/10.1007/s15010-002-3019-8
- Garg RK. Tuberculosis of the central nervous system. Postgrad Med J 1999;75:133–40.
- Rao GP. Spinal intramedullary tuberculous lesion: medical management. Report of four cases. J Neurosurg 2000;93:137–41.
- Sureka J, Samuel S, Keshava SN, Venkatesh K, Sundararaj GD. MRI in patients with tuberculous spondylitis presenting as vertebra plana: a retrospective analysis and review of literature. Clin Radiol 2013;68:e36–42. https://doi.org/10.1016/j.crad.2012.09.004
- Dastur HM. Diagnosis and neurosurgical treatment of tuberculosis disease of the CNS. Neurosurg Rev 1983;6:111–7.
- Konar SK, Rao KN, Mahadevan A, Devi BI. Tuberculous lumbar arachnoiditis mimicking conus cauda tumor: A case report and review of literature. J Neurosci Rural Pract 2011;2:93–6. https://doi. org/10.4103/0976-3147.80098
- Citow JS, Ammirati M. Intramedullary tuberculoma of the spinal cord: case report. Neurosurgery 1994;35:327–30.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Case Report |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2018 |
| Yayımlandığı Sayı | Yıl 2018Sayı: 2 |