1/51. spinal cord sarcoidosis presenting as an intramedullary mass: a case report.A case of spinal cord sarcoidosis mimicking an intramedullary tumor is reported because of its rarity and difficulty in diagnosis before surgery. A 66-year-old woman began to suffer from chronic thoracic myelopathy in August, 1996. She had a history of intrathoracic sarcoidosis with left hilar adenopathy in 1991, which disappeared completely after steroid therapy for one month. magnetic resonance imaging of the T-spine performed on 4 June, 1997, showed normal appearance in T1-weighted and T2-weighted images but abnormal enhancement at the T10-11 level. Open biopsy revealed noncaseating granulomatous inflammation and perivascular lymphocytic infiltration. Following biopsy, methylprednisolone 750 mg was given daily for three days followed by prednisolone 60 mg per day. The patient was discharged on 10 July, 1997, in a stable condition. She died on 22 July, 1997, at a local hospital due to urinary tract infection with sepsis.- - - - - - - - - - ranking = 1keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
2/51. spinal cord granulomatous vasculitis: an unusual clinical presentation of sarcoidosis.A 52-year-old Caucasian man presented with isolated manifestations of myelopathy. Cervical magnetic resonance imaging showed a focus of increased signal intensity at the posterolateral left half of C5 and C6. biopsy of spinal cord revealed the presence of active vasculitis associated with noncaseating granulomas. The patient responded to the combination of methotrexate (MTX) and corticosteroid treatment. Low-dose MTX was an effective, steroid-sparing regimen. This is a rare condition of isolated spinal cord involvement associated with sarcoid vasculitis.- - - - - - - - - - ranking = 0.7277908938932keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
3/51. An MR image of spinal cord sarcoidosis.We present a case of spinal cord sarcoidosis with a unique magnetic resonance imaging (MRI) finding. MRI of the cervical spine revealed an unusual lesion of low signal intensity on T2-weighted image at the core of the lesion surrounded by high signal intensity. T1-weighted gadolinium enhanced image showed a high signal at the core lesion. Low signal intensity on T2-weighted image in the case was suggested to be due to hemosiderin deposition. Steroid therapy dramatically improved clinical symptoms with a marked reduction of peripheral T2 high intensity area and the core lesion size detected by gadolinium enhancement.- - - - - - - - - - ranking = 0.83333333333333keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
4/51. Intramedullary sarcoidosis presenting as incomplete paraplegia: case report and literature review.sarcoidosis is a chronic, multisystem noncaseating granulomatous disease of unknown etiology. sarcoidosis typically presents clinically in individuals between the ages of 20 and 40 years. Although sarcoidosis most commonly affects the respiratory system, nearly any organ system can be involved. spinal cord involvement by sarcoidosis is a rare event, occurring in less than 1% of patients with systemic disease. The case presented is that of a 29-year-old black male with benign past medical history who presented with a 6-week history of progressive incomplete paraplegia and bowel dysfunction. magnetic resonance imaging revealed an intramedullary mass at the T-4-T-5 levels. The patient underwent thoracic laminectomy and debulking of the mass. The pathology was consistent with granulomatous disease. Postoperatively, the patient was placed on prednisone. He subsequently received comprehensive inpatient and outpatient rehabilitation and at present is bowel and bladder continent and ambulating at community levels with a rolling walker. The diagnosis of sarcoidosis; potential treatment options, including debulking and long-term steroid use; and prognosis will be discussed.- - - - - - - - - - ranking = 1.1666666666667keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
5/51. Extensive leptomeningeal and intraparenchymatous spinal cord neurosarcoidosis.This case of neurosarcoidosis of the spinal cord involved several meningeal areas and spinal cord levels. It appears to be the tenth autopsy-documented case of neurosarcoidosis of the spinal cord, though the patient had more extensive spinal cord disease than has been previously reported.- - - - - - - - - - ranking = 1keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
6/51. Differential response to corticosteroid therapy of MRI findings and clinical manifestations in spinal cord sarcoidosis.spinal cord sarcoidosis is a rare disorder whose natural history and therapeutic outcome are not fully known. We examined four patients with spinal cord sarcoidosis both clinically and radiologically, particularly in relation to corticosteroid treatment. The initial manifestation was cervical myelopathy in three and uveitis in one. All four patients progressed slowly until corticosteroid therapy was initiated. The cervical spine was involved in all patients. magnetic resonance imaging (MRI) who showed spinal cord swelling with T2-weighted high intensity and linear leptomeningeal and patchy or diffuse intramedullary enhancement with gadolinium diethylene triamine-pentaacetic acid. With corticosteroid therapy, dramatic improvement was seen on MRI, including disappearance or marked reduction of swelling and enhancement. plasma levels of angiotensin-converting enzyme (ACE) were also markedly improved. In contrast, the clinical symptoms were little improved in one patient, unchanged in two, and rather worsened in one patient. recurrence was seen on MRI at the maintenance dose in all four patients, without any dramatic change in clinical manifestation. MRI findings and plasma ACE are well correlated with active lesion of the spinal cord sarcoidosis, providing a useful marker for recurrence, but do not parallel the clinical manifestations.- - - - - - - - - - ranking = 1.1666666666667keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
7/51. Solitary intramedullary neurosarcoidosis: role of MRI in early detection.BACKGROUND: Intramedullary neurosarcoidosis may be the first manifestation of the disease and may mimic a tumor clinically and radiographically. Two patients who presented with cervical intramedullary lesions on magnetic resonance imaging (MRI) scans were found to have neurosarcoidosis. CLINICAL PRESENTATION: Two patients with negative past medical history presented with progressive myelopathic features, and intramedullary cervical lesions were detected on MRI scan; the diagnosis was made on biopsy of the lesions. Early therapeutic intervention led to a favorable outcome. CONCLUSION: Intra-medullary neurosarcoidosis, especially in the cervical cord, can be the initial presentation of the disease, mimicking a tumor. MRI scan, biopsy, and, in fewer cases, angiotensin-converting enzyme levels can help with the diagnosis and may lead to a favorable outcome.- - - - - - - - - - ranking = 1.1666666666667keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
8/51. sarcoidosis presenting as an intramedullary spinal cord lesion.OBJECTIVES: sarcoidosis affects the spinal cord in only 0.43% of patients with sarcoidosis. Usually there is systemic involvement prior to the development of cord lesions. We present a case of sarcoid isolated to the intramedullary spinal cord, which was a diagnostic and therapeutic challenge. We review the case and then present a review of the literature with an emphasis on presentation, diagnosis and treatment. methods: We have reviewed a patient who presented with an isolated sarcoid granuloma affecting the cervical spinal cord. All pertinent history and physical information was extracted from the patient's chart and through patient interview. Laboratory, radiographic and pathological investigations are presented. RESULTS AND CONCLUSIONS: Fourteen patients have been reported with isolated intramedullary spinal cord sarcoidosis. Current practice supports the role of surgery for biopsy; mainstay of treatment is corticosteroids.- - - - - - - - - - ranking = 0.4555817877864keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
9/51. spinal cord sarcoidosis: a diagnostic dilemma.sarcoidosis is a chronic disorder of unknown etiology characterized by the development of non-caseating granulomas with derangement of the normal tissue architecture. Compromise of the spinal cord is one of the rarest neurologic manifestations of the disease, which may be clinically and radiologically indistinguishable from a spinal cord malignant tumor. However, neurosarcoidosis can be treated with steroids. This study reviews the clinical, radiological, and pathological features of the sarcoid compromise of the spinal cord, emphasizing the difficulties commonly encountered in making a diagnosis.- - - - - - - - - - ranking = 0.89445756055987keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
10/51. sarcoidosis of the spinal cord. Case report.A case of intramedullary sarcoidosis simulating a tumor of the cervical spinal cord is presented. autopsy showed that the disease was limited to the cervical cord and hilar lymph nodes. The literature is reviewed and six cases of histologically documented spinal cord sarcoidosis are discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = sarcoidosis, sarcoid (Clic here for more details about this article) |
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