Learning objectives
To highlight the spectrum of neuroradiological manifestations associated with diffuse parenchymal lung diseases (DPLDs).
Background
DPLDs comprise a complex group of more than 200 diseases including sarcoidosis,
Langerhans cell hystiocytosis (LCH),
lymphangioleiomyomatosis (LAM),
and vasculitis.
Some of them are associated with multisystemic manifestations,
of which cerebral involvement results in significant morbidity and mortality.Intracranial lesions have been observed during the course of the disease in patients with known disease,
but they also can precede the diagnosis of these disorders as the first presenting manifestation,
in which case they can cause considerable diagnostic problems.
Findings and procedure details
Sarcoidosis:
·Definition:
Sarcoidosis is a multisystem disorder characterized by the development of noncaseating granulomas,
frequently found in relation with lymphatics.
Often called the “great mimicker”,
it can involve many organs with multiple clinical presentations,
with most of them related to pulmonary,
skin and ocular involvement[1].
It typically presents in young and middle-age adults under the age of 50 years,
although children and elderly may also be affected.
The diagnosis is established when clinic-radiological findings are supported by histological evidence of noncaseating epithelioid granulomas (Fig.
1,2)[2]....
Conclusion
DPLDs as manifestation of systemic disease shouldprompt a careful diagnostic search for additional intracranial specific lesionsin the presence of neurological symptoms.
References
1.Ganeshan D et al.
Sarcoidosis from Head to Toe: What the Radiologist Needs to Know.
Radiographics.
2018;38(4):1180-200.
2.Statement on sarcoidosis.
Joint Statement of the American Thoracic Society (ATS),
the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee,
February 1999.
Am J Respir Crit Care Med.
1999;160(2):736-55.
3.Iannuzzi MC etal.
N Engl J Med.
2007;357(21):2153-65.
4.Chapman MN et al.
Sarcoidosis in the Head and Neck: An...