Neuroimaging: tuberculoma: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: tuberculoma

Sample item

A child from an endemic area has seizures and a single ring-enhancing parenchymal lesion with a relatively T2-hypointense centre. MR spectroscopy shows a lipid-lactate peak. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Tuberculoma

A caseating granuloma has solid central caseation that is dark on T2, with a lipid peak on spectroscopy. A cysticercus cyst shows an eccentric scolex and a pyogenic abscess has a bright cavity with restricted diffusion.

Option by option

  • A. Glioblastoma

    Glioblastoma is an irregular thick-walled necrotic mass with extensive oedema in adults.

  • B. Tuberculoma (correct)

    Correct. A T2-dark centre with a lipid peak points to a tuberculoma.

  • C. Neurocysticercosis in the colloidal vesicular stage

    Neurocysticercosis shows an eccentric dot (scolex) within a cyst, with a smaller lesion size.

  • D. Pyogenic abscess

    A pyogenic abscess has a T2-bright liquid centre with markedly restricted diffusion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Tuberculoma. A caseating granuloma has solid central caseation that is dark on T2, with a lipid peak on spectroscopy.

Why is "Glioblastoma" not the answer?

Glioblastoma is an irregular thick-walled necrotic mass with extensive oedema in adults.

Why is "Neurocysticercosis in the colloidal vesicular stage" not the answer?

Neurocysticercosis shows an eccentric dot (scolex) within a cyst, with a smaller lesion size.

Why is "Pyogenic abscess" not the answer?

A pyogenic abscess has a T2-bright liquid centre with markedly restricted diffusion.

What concept does this question test?

It tests Neuroimaging: tuberculoma in Radiology. A cysticercus cyst shows an eccentric scolex and a pyogenic abscess has a bright cavity with restricted diffusion.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: tuberculoma?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.