BMJ Case Reports 2015; doi:10.1136/bcr-2014-206171

Mycobacterial spindle cell pseudotumour of the brain in a patient with sarcoidosis

  1. Heinke Kunst4
  1. 1Department of Respiratory Medicine, Heart of England NHS Foundation Trust, Sutton Coldfield, West Midlands, UK
  2. 2Department of Pathology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK
  3. 3Department of Pathology, Heart of England NHS Foundation Trust, Birmingham, West Midlands, UK
  4. 4Department of Respiratory Medicine, Queen Mary University Hospital, London, London, UK
  1. Correspondence to Dr Iyad Ismail, iyad75{at}
  • Accepted 9 June 2015
  • Published 7 July 2015


Mycobacterial spindle cell pseudotumours (MSP) are benign lesions characterised by local proliferation of spindle-shaped histiocytes caused by mycobacterial infections. Cerebral MSP due to Mycobacterium avium intracellulare (MAI) infection is rare, and is often misdiagnosed clinically and radiologically as a brain tumour. We present a case with underlying sarcoidosis and known pulmonary MAI infection presenting with partial seizures and headaches. Imaging of the brain revealed a solitary extra axial tumour within the right temporal area. Biopsy of the tumour showed evidence of MPS due to MAI infection. Prolonged treatment with antituberculous therapy showed complete resolution of the cerebral lesion.

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