Probst-Cousin S, Bergmann M, Janus J, Terwey B, Sandvoss G, Piscol K
Institut für Klinische Neuropathologie, Zentralkrankenhaus Bremen-Ost.
Zentralbl Neurochir. 1996;57(1):37-43.
Neurosarcoidosis mimicking CNS tumours represents a rare manifestation of Schaumann's disease. The central or peripheral nervous system is clinically involved in 5% of sarcoidosis, basal parts of the brain being mainly affected by the inflammation. This location of the process causes basal meningitis with cranial nerve paresis as well as parenchymal granulomatosis around the third ventricle and hypophysis. Solid, space-occupying lesions rarely occur, evoking problems in the differentiation from cerebral tumours. We report three cases of neurosarcoidosis presenting as intracranial tumours, where a space-occupying lesion was the first of only manifestation of sarcoidosis. The lesions in our cases were found in parietal and parieto-occipital cortex and in the fourth ventricle and vermis cerebelli, respectively. These locations are unusual, since most of the reported cases were affecting the temporal lobe. We review the literature and discuss the role of neurosarcoidosis in the differential diagnosis of intracranial tumours.
类肉瘤病酷似中枢神经系统肿瘤是绍曼病的一种罕见表现。在类肉瘤病患者中，有5%的人中枢或周围神经系统会出现临床症状，脑部基底部分主要受到炎症影响。这一发病部位会引发基底脑膜炎并伴有颅神经麻痹，以及第三脑室和垂体周围的实质肉芽肿。实体性占位性病变很少出现，这给与脑肿瘤的鉴别诊断带来了困难。我们报告了3例表现为颅内肿瘤的神经类肉瘤病病例，其中占位性病变是类肉瘤病的首个也是唯一表现。我们病例中的病变分别位于顶叶和顶枕叶皮质以及第四脑室和小脑蚓部。这些部位并不常见，因为大多数已报告病例累及颞叶。我们回顾了文献并讨论了神经类肉瘤病在颅内肿瘤鉴别诊断中的作用。
