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ABSTRACT: Sarcoidosis is an inflammatory granulomatous disease affecting multiple organ systems. Neurosarcoidosis (central nervous system involvement) is seen in approximately 25% of patients with systemic sarcoidosis, although it is subclinical in most of these cases. Clinical presentations and imaging findings in nervous system were varied. Cranial nerve abnormalities were the most common clinical presentation and involvement of the optic nerve in particular was associated with a poor prognosis for visual recovery. A patient is described who presented with decreased visual acuity, hypoesthesia of the face and multiple tumors of the eyelids on both eyes. Initial biopsy of one of the tumor of the eyelids revealed a non-caseating granulomatous inflammatory process with nodular infiltrates made up of epithelioid cells, Langhans-type giant multinucleated cells and mononuclear cells; the diagnosis of sarcoidosis was suspected. After two years of clinical and MRI (Magnetic Resonance Imaging) follow up, the diagnosis of isolated neurosarcoidosis was confirmed by histology. In this study, we analyzed clinical and radiologic records of this patient with biopsy proven and clinically diagnosed neurosarcoidosis for the following reasons: (1) to assess the concordance between abnormalities noted on MRI with neurologic symptoms at presentation; (2) to correlate changes in imaging findings during follow-up with clinical worsening; and (3) to show up the characteristic feature of this case with no general sign/symptoms of sarcoidosis.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie 01/2011; 52(3 Suppl):1139-42. · 0.62 Impact Factor