Recently, Prof. Mohamed et al. from Gandhi Institute of Medical Sciences, India, published a case report in the latest issue of AJNR Journal, Can you diagnose based on history and imaging findings alone? The patient was a 42-year-old male with chronic headache with seizures. Figure A: Cross-sectional MRI T2 image shows a heterogeneous lesion in the right frontal lobe with angioedema around the lesion. The edema is compressing the ipsilateral lateral ventricle and the midline is shifted to the left; Figure B: Cross-sectional MRI T1 image with contrast enhancement shows circumferential enhancement of the mass, along with inhomogeneous enhancement in the anterior part of the lesion (indicated by an asterisk in the figure), and several scattered punctate enhancements. Figure C: DWI image without diffusion restriction; Figure D: MRS with only one lipid-lactate peak and no other peaks. Central nervous system tuberculoma is a common disease in developing countries and is an occupying lesion of the brain or spinal cord parenchyma, with cerebral tuberculoma accounting for the majority of cases. Tuberculoma is neither a complication of stable tuberculous meningitis nor an incurable advanced lesion, and less than 10% of tuberculomas are associated with tuberculous meningitis. Clinical manifestations: fever, cough, and weight loss. In typical neurologic TB, the caseous necrotic material does not cause any diffusion restriction; 3. The ring-shaped lesions that appear with contrast can be easily mistaken for tumor necrosis; 4. The outer wall of the lesion will show high signal due to low magnetic transformation. Differential diagnosis: tumor necrosis; pyogenic abscess; tumor-like demyelinating lesion. Treatment: Anti-tuberculosis treatment and surgery if necessary.