Diffuse neurosarcoidosis involving only the leptomeninges of the brainstem and spinal cord

Abstract

MRI findings of sarcoidosis are usually intraparenchymal granuloma with leptomeningeal lesions. This appearance is dependent upon leptomeningeal lesions subsequently infiltrating to parenchyma. We describe a 52-year-old man with slowly progressive paresthesias and weakness in his legs. MRI showed diffuse leptomeningeal lesions throughout the brainstem and spinal cord without intraparenchymal lesions. A diagnosis of sarcoidosis was confirmed by cervical lymph node biopsy which detected noncaseating granuloma. Only leptomeningeal lesions throughout the brainstem and spinal cord could be observed in sarcoidosis. © 2009 The Japanese Society of Internal Medicine.