 |  |  |
| T1 coronal post gad | T1 axial post gad | T2 axial |
Diagnosis: Neurosarcoidosis
Sarcoidosis affects the CNS in 5% of cases. The typical appearance is enhancement of the basal leptomeninges with extension into the basal ganglia and thalami via the Virchow-Robins spaces. Neurosarcoidosis presenting as a parenchymal mass without leptomeningeal enhancement is unusual. If you are a Jeddi radiologist, the relative prominence of the pituitary infundibulum might tip you off to sarcoid. Lymphoma is a good consideration, however the younger age of the patient and the fact that the lesion is not periventricular go slightly against it. Ganglioglioma is a possibility without the CXR, particularly since this lesion involves the cortex and the patient is young. Gangliogliomas usually have a cystic component and variable enhancement. Pilocytic astrocytoma is a thought, but these also tend to have a cystic component and usually occur adjacent to the third or fourth ventricle or in the posterior fossa. Related Cases
