Tuberc Respir Dis.  2007 Jun;62(6):549-553.

A Case of Pulmonary Sarcoidosis Combined with Neurosarcoidosis

• Park BH
• Park SC
• Shin SY
• Jeon HH
• Jung KS
• Jung WY
• Byun MK
• Moon JA
• Kim YS
• Kim SK
• Chang J
• Kim SK
• Park MS

Abstract

Sarcoidosis is a multi-systemic syndrome of an unknown etiology, and it is characterized by the formation of multiple noncaseating granulomas that disrupt the architecture and function of the tissues in which they reside. The most commonly affected organs are lung, skin and lymph nodes. Overt clinical involvement of the nervous system is uncommon and this occurs in about 5% of all patients during the course of their disease. The most common manifestations are granulomatous leptomeningitis, cranial nerve palsy, electrolyte or other endocrinologic abnormalities, but isolated memory impairment is a rare manifestation. This is a case of 59 years-old male with recent memory impairment, and he was previously diagnosed with pulmonary sarcoidosis by transbronchial lung biopsy. The brain MRI imaging revealed the leptomeningeal and parenchymal involvement of sarcoidosis. He was treated with high dose corticosteroid and his memory function was improved to nearly a normal level. We report here on a case of successful treatment of pulmonary sarcoidosis combined with neurosarcoidosis with using high dose corticosteroid, and the patient presented with recent memory impairment.

Keyword

Sarcoidosis; Neurosarcoidosis; Central nervous system

MeSH Terms

Biopsy
Brain
Central Nervous System
Cranial Nerve Diseases
Granuloma
Humans
Lung
Lymph Nodes
Magnetic Resonance Imaging
Male
Memory
Middle Aged
Nervous System
Sarcoidosis
Sarcoidosis, Pulmonary*
Skin

Figure

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  Figure 1 Initial chest PA (1A) and CT scans (1B) showed numerous ill-defined nodules scattered in both lungs with peri-lymphatic distribution and upper lung predominancy. There is no lymph node enlargement on both hilum, mediastinum, and supraclavicular fossa.

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  Figure 2 Gadolinium-enhanced T1-weighted axial image of brain MRI showed increased nodular leptomeningeal enhancement in basal cistern, sylvian fissure, interhemispheric fissure, tentorium and brain stem, suggestive of neurosarcoidosis (2A). After high-dose corticosteroid treatment, brain MRI showed a remarkable improvement of neurosarcoidosis (2B).

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