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Isolated neurosarcoidosis - MR findings and pathologic correlation
M K Bode1, T Tikkakoski, S Tuisku
1Department of Radiology, Keski-Pohjanmaa Central Hospital, Kokkola, Finland.
Acta Radiologica (Stockholm, Sweden : 1987)
|December 12, 2001
Summary
Isolated neurosarcoidosis, a rare neurological condition, can present without systemic symptoms. This case highlights optic nerve and spinal cord involvement, emphasizing the need for thorough investigation in suspected neurosarcoidosis.
Area of Science:
- Neurology
- Immunology
- Radiology
Background:
- Neurosarcoidosis presents diagnostic challenges, particularly when systemic symptoms are absent.
- Isolated neurosarcoidosis requires careful consideration in differential diagnoses.
Observation:
- A 49-year-old woman presented with isolated neurosarcoidosis, primarily manifesting as left eye vision loss.
- Brain MRI revealed white matter lesions and optic nerve abnormalities, including increased signal intensity in the left optic nerve, a previously undocumented finding in sarcoid optic neuropathy.
- Spinal MRI demonstrated extensive leptomeningeal enhancement and nerve root lesions mimicking tumor seeding.
Findings:
- Biopsy of a nerve root mass confirmed non-caseating granulomas, consistent with sarcoidosis.
- The findings underscore the diverse and sometimes subtle manifestations of neurosarcoidosis.
Implications:
- This case expands the understanding of neurosarcoidosis imaging findings, particularly optic nerve and spinal leptomeningeal involvement.
- Highlights the importance of comprehensive neuroimaging in diagnosing isolated neurosarcoidosis.
- Suggests considering neurosarcoidosis in the differential diagnosis of unexplained optic neuropathy and spinal leptomeningeal disease.