Brain, Sarcoidosis [LMP36366]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Acute and Chronic Inflammation
Diagnosis: 
Sarcoidosis
Species: 
Human
Organ System: 
Central Nervous System
Gender: 
Male
Age: 
31 years
Diagnosis Code: 
ICD-10: D86.8
Slide Contributor Information
Gao, A., Munoz, D.

Keywords

sarcoid, granuloma, granulomatous inflammation, Neurosarcoidosis

Clinical History

31-year-old man with many months history of confusion, gait abnormality, and episodic drowsiness. Neuroimaging shows multiple scattered leptomeningeal lesions, especially concentrated in the sellar region.

Clinical Discussion

Sarcoidosis is an idiopathic systemic disease characterized by non-necrotizing granulomas in many organs and tissues. Lung and hilar lymph node involvement is most common, followed by skin and eyes. Nervous system involvement is termed neurosarcoidosis and may present as cranial or peripheral neuropathy, meningeal disease, parenchymal disease, or myelopathy. Microscopically, non-necrotizing granulomas are typically seen, but other causes of granulomatous inflammation must be excluded (as was in this case). Treatment is with steroids and immunosuppression.