PMC4427073_01
Multifocal T2 magnetic resonance image showing high signal intensity noted in parasagittal left frontoparietal region; there is intense punctuate enhancement post-gadolinium contrast (white arrows).
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A magnetic resonance image of the brain was done concluding multifocal enhancing foci suggestive of an infective process (Figure 1).
MDCT Helical axial cut of the pelvis showing the prostate is enlarged with a faint ring enhancing lesion measuring 3x2.7x3 cm (white arrow).. Note: The lesion takes up most of the right side of the prostate, extending to the right seminal vesicles.. Abbreviation: MDCT, multiple detector computed tomography.
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Light microscopy examination of the needle core prostatic biopsy showing multiple necrotizing granulomata with giant cells (white arrow), high suspicion of infective etiology; in particular mycobacterium bacteria.
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The biopsy showed multiple slides of necrotizing granulomata suggestive of tuberculosis (Figure 3).
Ziehl-Neelsen histochemical stain prepared on the paraffin block tissue showed positive staining of rare occasional acid-fast bacilli (white arrow) within the epithelioid granulomata and necrotic debris, confirming mycobacterium bacteria.
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Ziehl-Neelsen stain was also performed, and the diagnosis of miliary tuberculosis was confirmed (Figure 4).