A case of neurosarcoidosis with necrotizing granuloma expressing angiotensin-converting enzyme

We described a case of neurosarcoidosis with necrotizing sarcoid granulomatosis in a 22-year-old man. Contrast-enhanced brain computed tomography scan and magnetic resonance imaging showed intracerebral multiple nodular lesions. Noncaseating and partial necrotizing granulomas were detected in the sp...

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Bibliographic Details
Published in:Modern rheumatology 2010-10, Vol.20 (5), p.506-510
Main Authors: Kitajima, Shinji, Sakai, Norihiko, Furuichi, Kengo, Tomokage, Miki, Hara, Akinori, Kitagawa, Kiyoki, Sawada Kitamura, Seiko, Zen, Yoh, Nakada, Mitsutoshi, Kaneko, Shuichi, Wada, Takashi
Format: Article
Language:English
Subjects:
ACE inhibitors
Brain - diagnostic imaging
Brain - pathology
Brain - surgery
Case Report
Central Nervous System Diseases - complications
Central Nervous System Diseases - enzymology
Central Nervous System Diseases - pathology
Central Nervous System Diseases - surgery
Epilepsy - complications
Epilepsy - pathology
Granuloma - complications
Granuloma - enzymology
Granuloma - pathology
Granuloma - surgery
Humans
Immunohistochemistry
Lymph Nodes - pathology
Magnetic Resonance Imaging
Male
Medical treatment
Medicine
Medicine & Public Health
Necrosis
Orthopedics
Peptidyl-Dipeptidase A - blood
Radiography, Thoracic
Rheumatology
Sarcoidosis - complications
Sarcoidosis - enzymology
Sarcoidosis - pathology
Sarcoidosis - surgery
Tomography, X-Ray Computed
Young Adult
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Description
Summary:We described a case of neurosarcoidosis with necrotizing sarcoid granulomatosis in a 22-year-old man. Contrast-enhanced brain computed tomography scan and magnetic resonance imaging showed intracerebral multiple nodular lesions. Noncaseating and partial necrotizing granulomas were detected in the specimen resected by neurosurgery. In addition, immunohistochemical examination revealed the expression of angiotensin-converting enzyme in necrotizing granuloma. Thus, these findings were consistent with neurosarcoidosis. Clinical and pathological presentation, immunological features, and treatment modalities of neurosarcoidosis are discussed.
ISSN:1439-7595
1439-7609
DOI:10.1007/s10165-010-0301-y