Tuberculous Tonsillitis and Tuberculoma

This is a 32-year-old male with a history of fever, night sweats, and sore throat for greater than one week. The first image, a noncontrast sagittal T1-weighted sequence, demonstrates numerous enlarged cervical lymph nodes. There is asymmetric enlargement of the left faucial tonsil with peripheral enhancement and central necrosis on the fat-saturated postcontrast T1-weighted sequence, image 2. More inferiorly within the neck, image 3, the numerous enlarged cervical nodes demonstrate avid postcontrast enhancement. A solitary tuberculoma involving the left brachium pontis and left cerebellar hemisphere is identified on the axial T2 and fat-saturated postcontrast T1-weighted images. The final image, a fat-saturated coronal T1-weighted sequence with contrast demonstrates the enlarged lymph nodes and tuberculoma. Tuberculous inflammatory cervical adenitis, or scrofula, usually presents as a painless posterior neck mass or masses with or without systemic symptoms. Symptoms from an intracranial tuberculoma are usually the result of local mass effect and associated edema. Tuberculomas may be solitary or multiple and occur in both the supra- and infratentorial compartments.