Comparative histopathological and immunohistochemical features of central nervous system and pulmonary tuberculosis: an exploratory retrospective study.
- 1Hohhot Hospital of Traditional Chinese Medicine and Mongolian Medicine, Hohhot, China.
- 2Eighth Medical Center of the Chinese PLA General Hospital, Beijing, China.
- 3Henan University of Chinese Medicine, Zhengzhou, China.
Abstract
Central nervous system tuberculosis (CNS-TB) is a rare and particularly severe form of extrapulmonary tuberculosis (EPTB). Early diagnosis and precise treatment are crucial in managing this condition. Pathological and immunohistochemical features may differ between CNS-TB and pulmonary tuberculosis (PTB). This study included 9 patients of CNS-TB, and analyzed their clinical manifestations, pathological features, and the immunohistochemical(IHC) features. The findings were then compared with PTB to explore the similarities and differences in how tuberculosis manifests in the brain versus the lungs. However, CNS-TB tissue specimens are difficult to obtain, limiting our sample size. Additionally, several patients received preoperative anti-tuberculosis therapy and short-course corticosteroids before sampling. Given these baseline differences, intergroup comparisons should be interpreted cautiously. Unlike patients with isolated PTB, those with CNS-TB frequently present with multisystem tuberculosis involving the lungs. Typical tuberculosis manifestations including fever, anorexia, weight loss, dizziness and lymphadenopathy did not differ between groups. Likewise, CBC parameters (hemoglobin, total white blood cell count, absolute neutrophil count and lymphocyte count) were comparable between CNS-TB and PTB groups. In this small cohort, general pathological features such as granulomas and caseous necrosis were similar in CNS-TB and PTB lesions. We further compared their IHC profiles. This exploratory analysis revealed that CNS-TB lesions harbored significantly fewer CD34⁺ microvessels, CD4⁺ T cells and CD38⁺ cells relative to PTB lesions, while CD56⁺ cells were mildly elevated in CNS-TB. No marked intergroup differences were noted for other immune cell subsets. Collectively, pathological characteristics and immune cell infiltration may differ between CNS-TB and PTB. Owing to the absence of normal brain and lung tissue controls, our findings warrant cautious interpretation. Finally, we performed exploratory drug-resistance analysis using remaining specimens from four patients in each group and observed similar resistance-associated mutation profiles between CNS-TB and PTB lesions.
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BibTeX
@article{su2026comparative,
title = {{Comparative histopathological and immunohistochemical features of central nervous system and pulmonary tuberculosis: an exploratory retrospective study.}},
author = {Kaili Su and Junjun Liu and Runrui Wu and Wen Chen and Yuejiao Liu and Yadong Liu and Xu Zhang and Min Fan and Libao Feng and Shuangshuang Zhao},
journal = {Frontiers in cellular and infection microbiology},
year = {2026},
month = oct,
doi = {10.3389/fcimb.2026.1933605},
url = {https://europepmc.org/article/MED/42898228},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative histopathological and immunohistochemical features of central nervous system and pulmonary tuberculosis: an exploratory retrospective study.
AU - Kaili Su
AU - Junjun Liu
AU - Runrui Wu
AU - Wen Chen
AU - Yuejiao Liu
AU - Yadong Liu
AU - Xu Zhang
AU - Min Fan
AU - Libao Feng
AU - Shuangshuang Zhao
PY - 2026
DA - 2026/10/05
JO - Frontiers in cellular and infection microbiology
DO - 10.3389/fcimb.2026.1933605
UR - https://europepmc.org/article/MED/42898228
AB - Central nervous system tuberculosis (CNS-TB) is a rare and particularly severe form of extrapulmonary tuberculosis (EPTB). Early diagnosis and precise treatment are crucial in managing this condition. Pathological and immunohistochemical features may differ between CNS-TB and pulmonary tuberculosis (PTB). This study included 9 patients of CNS-TB, and analyzed their clinical manifestations, pathological features, and the immunohistochemical(IHC) features. The findings were then compared with PTB to explore the similarities and differences in how tuberculosis manifests in the brain versus the lungs. However, CNS-TB tissue specimens are difficult to obtain, limiting our sample size. Additionally, several patients received preoperative anti-tuberculosis therapy and short-course corticosteroids before sampling. Given these baseline differences, intergroup comparisons should be interpreted cautiously. Unlike patients with isolated PTB, those with CNS-TB frequently present with multisystem tuberculosis involving the lungs. Typical tuberculosis manifestations including fever, anorexia, weight loss, dizziness and lymphadenopathy did not differ between groups. Likewise, CBC parameters (hemoglobin, total white blood cell count, absolute neutrophil count and lymphocyte count) were comparable between CNS-TB and PTB groups. In this small cohort, general pathological features such as granulomas and caseous necrosis were similar in CNS-TB and PTB lesions. We further compared their IHC profiles. This exploratory analysis revealed that CNS-TB lesions harbored significantly fewer CD34⁺ microvessels, CD4⁺ T cells and CD38⁺ cells relative to PTB lesions, while CD56⁺ cells were mildly elevated in CNS-TB. No marked intergroup differences were noted for other immune cell subsets. Collectively, pathological characteristics and immune cell infiltration may differ between CNS-TB and PTB. Owing to the absence of normal brain and lung tissue controls, our findings warrant cautious interpretation. Finally, we performed exploratory drug-resistance analysis using remaining specimens from four patients in each group and observed similar resistance-associated mutation profiles between CNS-TB and PTB lesions.
SN - 2235-2988
ER -