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

Vol.20 No.5

Case Report

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

Authors

Shinji Kitajima¹ , Norihiko Sakai¹ , Kengo Furuichi¹ , Miki Tomokage¹ , Akinori Hara¹ , Kiyoki Kitagawa¹ , Seiko Sawada Kitamura² , Yoh Zen² , Mitsutoshi Nakada³ , Shuichi Kaneko¹ , Takashi Wada⁴

Department of Disease Control and Homeostasis, Institute of Medical, Pharmaceutical and Health Sciences, Faculty of Medicine, Kanazawa University
Department of Human Pathology, Institute of Medical, Pharmaceutical and Health Sciences, Faculty of Medicine, Kanazawa University
Department of Neurosurgery, Institute of Medical, Pharmaceutical and Health Sciences, Faculty of Medicine, Kanazawa University
Department of Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Faculty of Medicine, Kanazawa University

Received:

9 December 2009

Accepted:

25 March 2010

Published online:

25 May 2010

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Abstract

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.

Key words

Necrotizing sarcoid granuloma - Neurosarcoidosis