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Home arrow Environment arrow Inflammatory Disorders of the Nervous System: Pathogenesis, Immunology, and Clinical Management
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Neuropathology

On growth appearance, neurosarcoidosis most frequently involves the meninges at the base of the brain, particularly in the area of the infundibulum and optic chiasm, although it may involve other meningeal areas including the brain stem, convexities, cerebellum, and spinal cord. It may involve both cranial and spinal nerves where they traverse the meningeal space. The involved meninges are thickened, gray yellow, and frequently gelatinous (Fig. 5.1). Long-standing sarcoidosis results in progressively more fibrosis resulting in a tough fibrous-thickened membrane.

Occasional cases also exhibit involvement of the choroid plexus and/or ependymal lining of the ventricular system. Dural involvement is unusual but would have similar gross features.

Although less common, the granulomas of sarcoidosis may be seen within the parenchyma of the brain where they are usually small, discrete, gray, firm nodular lesions that may be solitary or multifocal. The infundibulum and hypothalamus are the favored parenchymal areas of involvement followed by the brain stem.

 
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