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Intracranial Aspergillus granuloma simulating meningioma on MR imaging

R Gupta1, A K Singh, P Bishnu

  • 1NMR Research Center, Institute of Nuclear Medicine and Allied Sciences, Delhi, India.

Journal of Computer Assisted Tomography
|May 1, 1990
PubMed

Insights

A rare intracranial granuloma caused by Aspergillus fumigatus was found in a non-immunocompromised patient. The imaging findings mimicked a meningioma, highlighting diagnostic challenges in fungal brain infections.

Area of Science:

  • Neurology
  • Mycology
  • Radiology

Background:

  • Intracranial granulomas are uncommon, particularly in non-immunocompromised individuals.
  • Fungal infections of the central nervous system can present with diverse and often subtle clinical and radiological features.

Observation:

  • A case of Aspergillus fumigatus granuloma in the anterior cranial fossa of an immunocompetent patient is presented.
  • The patient was asymptomatic prior to a traumatic accident.
  • Magnetic Resonance Imaging (MRI) revealed an isointense mass on T1- and T2-weighted images, mimicking a meningioma, with a characteristic pial vascular rim.

Findings:

  • Surgical resection and subsequent histopathological examination confirmed the diagnosis of Aspergillus fumigatus granuloma.
  • The radiological appearance, while suggestive, required definitive pathological confirmation.

Implications:

  • This case underscores the importance of considering fungal infections in the differential diagnosis of intracranial masses, even in immunocompetent hosts.
  • Accurate radiological interpretation and definitive histopathological analysis are crucial for diagnosing and managing such rare conditions.
  • Highlights the diagnostic challenges posed by fungal granulomas that can mimic common intracranial tumors like meningiomas.

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