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

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.

• Authors: Shinji Kitajima, Norihiko Sakai, Kengo Furuichi, Miki Tomokage, Akinori Hara, Kiyoki Kitagawa, Seiko Sawada Kitamura, Yoh Zen, Mitsutoshi Nakada, Shuichi Kaneko, Takashi Wada
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 20 Issue 5 Pg. 506-10 (Oct 2010) ISSN: 1439-7609 [Electronic] England
• PMID: 20499262 (Publication Type: Case Reports, Journal Article)

Chemical References

• Peptidyl-Dipeptidase A

Topics

• Brain (diagnostic imaging, pathology, surgery)
• Central Nervous System Diseases (complications, enzymology, pathology, surgery)
• Epilepsy (complications, pathology)
• Granuloma (complications, enzymology, pathology, surgery)
• Humans
• Lymph Nodes (pathology)
• Magnetic Resonance Imaging
• Male
• Necrosis
• Peptidyl-Dipeptidase A (blood)
• Radiography, Thoracic
• Sarcoidosis (complications, enzymology, pathology, surgery)
• Tomography, X-Ray Computed
• Young Adult