SARCOIDOSIS OF THE SPINAL-CORD AND MEDULLA-OBLONGATA

A case of 68-year-old woman with symptoms of slowly progessive diffuse myelopathy, is presented, which could only temporally be reversed by immunosupression. Contrast enhanced magnetic resonance (MR) scan demon strated multifocal patchy enhancing lesions from cervical to mild thor acic segment and a circumscribed lesion of the whole medulla oblongata . Postmorten examination disclosed a histological confirmed, multifoca l sarcoidosis of the spinal cord and medulla oblongata, with few sarco id granulomas in one hilar lymph node and skeletal muscle of the upper extremities. Only nine similar cases of intramedullary sarcoidosis co nfirmed by autopsy with symptoms solely attributable to the spinal cor d have been reported. A review of the pathological manifestations, dia gnostic and treatment of intramedullary sarcoidosis is given.