TUBERCULOMA

-a benign non-neoplastic tumor like mass caused by a localized tuberculosis infection due to formation of granuloma.

-mainly found in patients with tuberculosis, usually in the lungs or brain, spinal cord, but can also found in muscles, nerves, bones & other parts of the body.

-it may contain active tubercle bacilli & may spread to other parts of the body after caseation

– One of the main features of the immune response to M. Tuberculosis is the formation of an organized structure called granuloma. It consists mainly in the recruitment at the infectious stage of macrophages, highly differentiated cells such as multinucleated giant cells, epitheloid cells and Foamy cells, all these cells being surrounded by a rim of lymphocytes.

 

–Histopathology: 1. Immature stage: small tubercles composed of inflammatory cells (macrophages, lymphocytes, epitheloid cells & giant cells) & collagen-poor capsule                 2. Mature Stage:  caseation necrosis, inflammatory cellular infiltrates, and collagenous capsule.

– A tuberculoma may undergo calcification & healed, e.g. in lungs & brain; or, it may go into cavitation, e.g. in lungs & may change into active tuberculosis & also may spread to other parts of body.

– A tuberculoma in striated muscle may present as swelling locally & clinical presentation may vary.

– An intradural tuberculoma of the spinal cord or an extradural granuloma of the cord may present as “spinal tumor syndrome“- may cause neurological complications without any radiological evidence of tubercular lesion of vertebrae.

Treatment of tuberculoma: It responds to anti-tubercular treatment & anti-inflammatory medications.