PMC4977971_01
Preoperative images. (a) Hypointensity of the lesion and the isointensity of its peripheral rim are seen on axial T1-weighted imaging (T1WI). (b) Hyperintensity of the lesion and the hypointensity of its peripheral rim are seen on axial T2-weighted imaging (T2WI). (c) Hyperintense signals obtained using diffusion-weighted imaging. (d and e) Bilateral ring-enhanced lesions are seen on axial T1WI following the administration of Gd-DTPA as contrast agent. (f) A small nodule in the lingular segment of the left lung (arrow) is revealed by coronal thoracic computed tomography
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F1
T1-weighted imaging (T1WI) and hyperintense on T2-weighted imaging (T2WI) [Figure 1a and b]. The peripheral rim was isointense on T1WI and hypointense on T2WI [Figure 1a and b]. Diffusion-weighted imaging demonstrated a hyperintense region in the abscess cavity [Figure 1c]. The lesion was ring-enhanced after the administration of the contrast agent gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) [Figure 1d and e]. Whole-body computed tomography (CT) revealed small nodules in the lingular segment of the left lung [Figure 1f].
(a) Photomicrograph of the hematoxylin and eosin stained resected specimen shows numerous inflammatory cells around the abscess cavity, with a surrounding rim of fibrosis. (x100). (b) Smears from the capsule culture yielded gram-positive branching filaments, raising suspicion of a Nocardia species as the infectious agent
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F2
The diagnosis was, therefore, brain abscess [Figure 2a]. Smears from the capsule culture revealed gram-positive branching filaments, raising suspicion that the infecting bacterium was a Nocardia species [Figure 2b].