[Spinal cord sarcoidosis without abnormal shadows on chest radiography or chest CT diagnosed by transbronchial lung biopsy].
The patient was a woman aged 56 years. In February 1998, she complained of fatigability of the right upper limb and disturbed extension of the right fourth finger. Because her condition deteriorated gradually and myelopathic signs such as difficulty in walking developed, she was hospitalized in May 1999 for close examination and appropriate treatment; and she was a few days later transferred to our hospital because of progressive myelopathy. In T2-weighted MR images of the cervical spine, the high-intensity area ranged between C2 and Th1, and in Gd-DTPA enhanced MRI the high-intensity area was seen between C3 and C7. Although chest radiographs and chest CT scans were normal, spinal cord sarcoidosis could not be ruled out, and therefore, bronchoscopic examination was performed. Specimens obtained from transbronchial lung biopsy (TBLB) revealed non-caseating epithelioid cell granulomas, and so and the disease was diagnosed as spinal cord sarcoidosis. Both symptoms and MRI findings were improved by treatment with corticosteroids. It is suggested that, in patients suspected of spinal cord sarcoidosis from MRI findings. TBLB should be aggressively attempted, even if chest radiographs and chest CT scans are normal.
Morimoto
T
T
Department of Pulmonary Disease, Yokohama Rousai Hospital, 3211, Kozukue, Kouhoku, Yokohama, Kanagawa, 222-0036, Japan.
Takeuchi
K
K
Morikawa
T
T
Sakakibara
K
K
Yamasato
M
M
Uchikoshi
A
A
Sakamoto
K
K
Kawamura
S
S
Kakuta
Y
Y
Mikami
R
R
D001706:Biopsy; D001980:Bronchi / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013902:Radiography, Thoracic; D012507:Sarcoidosis / Q000175:diagnosis*; D013118:Spinal Cord Diseases / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed