MR demonstration of spinal cord sarcoidosis: report of a case.

Abstract

Sarcoidosis is an idiopathic, multisystem, granulomatous disease characterized microscopically by the presence of noncaseating granulomas and, in the majority of cases , sup­ portive laboratory and clinical findings. The CNS is clinically involved in approximately 5% of cases [1], although autopsy findings suggest an overall involvement of closer to 15% [2]. The CNS is the sole site of involvement in 1.5% of cases [3]. The most frequently affected portions of the CNS are the basal leptomeninges, cranial nerves (particularly VII and II), hypothalamus, and pituitary gland; the brainstem and spinal cord are rarely involved [1]. Hydrocephalus secondary to basal arachnoiditis is the most common CNS abnormality detected radiographically, although contrast-enhancing mass lesions produced by coalescent granulomata have occasion­ ally been demonstrated with CT [2-7]. Only one previous report [8] has described MR findings in a case of suspected neurosarcoidosis. We report a second case with MR findings in which histologically confirmed neu­ rosarcoidosis involved the brainstem and spinal cord.