Korean Circ J.  2011 Dec;41(12):750-753. 10.4070/kcj.2011.41.12.750.

A Newly Developed Pericardial Tuberculoma During Antituberculous Therapy

• Kim SM
• Park SJ
• Park JR
• Choi JH
• Yang JH
• Noh HJ
• Jo HC
• Choi SH
• Choe YH
• Park SW

• KMID: 1776252
• DOI: http://doi.org/10.4070/kcj.2011.41.12.750

Abstract

Tuberculosis generally affects the respiratory tract. In developing nations, the pericardium is the most common location of extrapulmonary tuberculosis; however, tuberculous pericarditis rarely appears as a localized mass or tuberculoma. We present here a case of a 62-year-old woman with pericardial tuberculoma. She had a history of effusive tuberculous pericarditis and drainage. Because she had taken regular medication over a period of six months, the pericardial mass with an adjacent lung nodule newly detected on the chest radiogram was initially suspected of being invasive lung cancer. Prior to pathologic confirmation, precise information from imaging tests, including computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography are helpful when making decisions regarding which methods should be used for surgical approach and treatment. Through imaging, our case showed typical features of pericardial tuberculoma and a favorable clinical course after two months with a change in antituberculous therapy.

Keyword

Tuberculosis; Magnetic resonance imaging

MeSH Terms

Developing Countries
Drainage
Electrons
Female
Humans
Lung
Lung Neoplasms
Magnetic Resonance Imaging
Middle Aged
Pericarditis, Tuberculous
Pericardium
Respiratory System
Thorax
Tuberculoma
Tuberculosis

Figure

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  Fig. 1 Rounded, bulging mass in the superior cardiac border and adjacent lung nodule arrow on chest X-ray.

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  Fig. 2 Pericardial mass protruding into the lung parenchyma in the superior-anterior aspect of the left ventricle (A) and mass with irregular margin and non-enhanced central necrosis on chest CT (B).

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  Fig. 3 The mass with hyper-enhanced rim and mixed signal intensity central core on delayed enhancement images.

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  Fig. 4 High glucose uptake of the left ventricle, pericardium, lung mass, and subcarinal lymph node on positron emission tomography-computed tomography.

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  Fig. 5 Previous bulging mass and adjacent lung nodule was not seen on the follow up chest X-ray.

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