A Case Report of Neurosarcoidosis Presenting as a Lymphoma Mimic
Objective. To describe a unique presentation of neurosarcoidosis. Background. Central nervous system involvement is rare in sarcoidosis. Sarcoidosis can be severe and can be mistaken for systemic lymphoma. Case Description. A 55-year-old right-handed white male with past medical history of obstructi...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2016/7464587 |
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| author | Gurcharanjeet Kaur Lauren Cameron Olga Syritsyna Patricia Coyle Agnes Kowalska |
| author_facet | Gurcharanjeet Kaur Lauren Cameron Olga Syritsyna Patricia Coyle Agnes Kowalska |
| author_sort | Gurcharanjeet Kaur |
| collection | DOAJ |
| description | Objective. To describe a unique presentation of neurosarcoidosis. Background. Central nervous system involvement is rare in sarcoidosis. Sarcoidosis can be severe and can be mistaken for systemic lymphoma. Case Description. A 55-year-old right-handed white male with past medical history of obstructive sleep apnea, Raynaud’s disease, and Hashimoto’s thyroiditis was noted to have cognitive decline over a duration of few weeks and 20 lb weight loss. His neurologic exam (including cranial nerves) was normal except for five-minute recall. Head CT revealed a lacrimal gland mass, confirmed on brain MRI, which was suspicious for lymphoma on brain PET/MRI. Subsequent whole-body FDG PET/CT scan showed multiple enlarged lymph nodes. Bone marrow biopsy was negative. Serum and CSF ACE levels were within normal limits. Supraclavicular lymph node biopsy before steroids therapy was initiated and revealed multiple noncaseating granulomas, diagnostic of “sarcoidosis.” He was treated with daily prednisone for two months, followed by weekly infliximab. Brain MRI two months after treatment with prednisone showed decrease in size of lacrimal lesion, and brain PET/MRI showed normal brain metabolism pattern after five months. Neurocognitive evaluation three months after diagnosis demonstrated improvements in memory abilities. Discussion. Both clinically and radiographically, neurosarcoidosis can mimic systemic lymphoma. Biopsy in these types of cases is necessary to establish the diagnosis. |
| format | Article |
| id | doaj-art-c1dde18672e8409ebf50f483e77dd4e9 |
| institution | OA Journals |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-c1dde18672e8409ebf50f483e77dd4e92025-08-20T02:19:15ZengWileyCase Reports in Neurological Medicine2090-66682090-66762016-01-01201610.1155/2016/74645877464587A Case Report of Neurosarcoidosis Presenting as a Lymphoma MimicGurcharanjeet Kaur0Lauren Cameron1Olga Syritsyna2Patricia Coyle3Agnes Kowalska4Department of Neurology, Stony Brook University Hospital, Stony Brook, NY, USADepartment of Neurology, Stony Brook University Hospital, Stony Brook, NY, USADepartment of Neurology, Stony Brook University Hospital, Stony Brook, NY, USADepartment of Neurology, Stony Brook University Hospital, Stony Brook, NY, USADepartment of Neurology, Stony Brook University Hospital, Stony Brook, NY, USAObjective. To describe a unique presentation of neurosarcoidosis. Background. Central nervous system involvement is rare in sarcoidosis. Sarcoidosis can be severe and can be mistaken for systemic lymphoma. Case Description. A 55-year-old right-handed white male with past medical history of obstructive sleep apnea, Raynaud’s disease, and Hashimoto’s thyroiditis was noted to have cognitive decline over a duration of few weeks and 20 lb weight loss. His neurologic exam (including cranial nerves) was normal except for five-minute recall. Head CT revealed a lacrimal gland mass, confirmed on brain MRI, which was suspicious for lymphoma on brain PET/MRI. Subsequent whole-body FDG PET/CT scan showed multiple enlarged lymph nodes. Bone marrow biopsy was negative. Serum and CSF ACE levels were within normal limits. Supraclavicular lymph node biopsy before steroids therapy was initiated and revealed multiple noncaseating granulomas, diagnostic of “sarcoidosis.” He was treated with daily prednisone for two months, followed by weekly infliximab. Brain MRI two months after treatment with prednisone showed decrease in size of lacrimal lesion, and brain PET/MRI showed normal brain metabolism pattern after five months. Neurocognitive evaluation three months after diagnosis demonstrated improvements in memory abilities. Discussion. Both clinically and radiographically, neurosarcoidosis can mimic systemic lymphoma. Biopsy in these types of cases is necessary to establish the diagnosis.http://dx.doi.org/10.1155/2016/7464587 |
| spellingShingle | Gurcharanjeet Kaur Lauren Cameron Olga Syritsyna Patricia Coyle Agnes Kowalska A Case Report of Neurosarcoidosis Presenting as a Lymphoma Mimic Case Reports in Neurological Medicine |
| title | A Case Report of Neurosarcoidosis Presenting as a Lymphoma Mimic |
| title_full | A Case Report of Neurosarcoidosis Presenting as a Lymphoma Mimic |
| title_fullStr | A Case Report of Neurosarcoidosis Presenting as a Lymphoma Mimic |
| title_full_unstemmed | A Case Report of Neurosarcoidosis Presenting as a Lymphoma Mimic |
| title_short | A Case Report of Neurosarcoidosis Presenting as a Lymphoma Mimic |
| title_sort | case report of neurosarcoidosis presenting as a lymphoma mimic |
| url | http://dx.doi.org/10.1155/2016/7464587 |
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