CTICasesSpinal Cord Sarcoidosis
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Imaging findings
Spine MRI demonstrates an enhancing intramedullary lesion near the conus medullaris. Contrast-enhanced chest CT shows symmetric bilateral hilar, mediastinal, and subcarinal lymphadenopathy. Pathological biopsy of both the spinal lesion and mediastinal lymph nodes confirms non-necrotizing granulomatous inflammation.
Key takeaways
Neurosarcoidosis is a rare manifestation of sarcoidosis, affecting less than 1% of patients, and can present as an isolated intramedullary spinal cord lesion mimicking a primary CNS glioma or metastasis. Evaluating the chest for characteristic symmetric hilar and mediastinal adenopathy can guide the diagnostic workup toward sarcoidosis, preventing aggressive spinal resections.
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