Diagnostic value of combined-diagnostic methods of brain tuberculoma tissue specimens: a case series

Abstract Background: The diagnosis of brain tuberculoma (BT) is sometimes challenging. Herein, we presented a case series to evaluate the combined-diagnostic methods, including acid-fast bacilli (AFB) stain, polymerase chain reaction (PCR), Gene Xpert and histopathology, of tuberculoma tissue specimens (TTSs). Methods: A total of 16 patients (11 HIV-positive, 5 HIV-negative) with BT confirmed by combined-diagnostic methods of TTS were included in this study. Clinical data, including clinical symptoms, laboratory tests, neuroimaging features, histopathology, treatment, and prognosis, were assessed in all patients. Results: There were 10 male and 6 female patients (range: 18-73 y). AFB stain and PCR of TTSs were positive in 11 and 10 patients, respectively. The sensitivity of Gene Xpert of TTSs was (80.0%, 8/10). 9 (56.3%, 9/16) patients were diagnosed with BT by histopathology.After receiving anti-tuberculosis treatment, 12 (75.0%, 12/16) patients improved clinically to a considerable extent. Conclusions: The combined-diagnostic methods of TTS may significantly improve the diagnostic efficiency of BT.