Noncalcified pulmonary tuberculomas: CT enhancement patterns with histological correlation

The objective of this study was to correlate enhanced CT images of noncalcified tuberculomas with histological findings, in order to search for characteristic CT enhancement patterns. Over 7 years, 12 noncalcified tuberculomas were surgically resected. Enhanced CT images of these tuberculomas were reviewed and correlated with histological studies. Ring or central-curvilinear enhancement was present in nine of 12 tuberculomas (75%). In those with ring or central-curvilinear enhancement, the low-density region was histologically confirmed to be caused by caseous or liquefied necrotic material, and a von Willebrand factor stain showed moderate to marked vascularity of the enhanced areas. Three tuberculomas showed nonspecific enhancement patterns. Histologically, each of these contained central caseous necrotic material, and two showed a poor vascularized peripheral fibrotic zone.