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IMAGES IN ACADEMIC MEDICINE
Year : 2015  |  Volume : 1  |  Issue : 1  |  Page : 41-44

Extensive periventricular white matter abnormality with mediastinal adenopathy


1 Department of Family Medicine, St. Luke's University Hospital Network, Bethlehem, Pennsylvania - 18015, USA
2 Department of Neuroradiology, St. Luke's University Hospital Network, Bethlehem, Pennsylvania - 18015, USA
3 Department of Pathology, St. Luke's University Hospital Network, Bethlehem, Pennsylvania - 18015, USA
4 Department of Internal Medicine, St. Luke's University Hospital Network, Bethlehem, Pennsylvania - 18015, USA

Correspondence Address:
Sudip Nanda
Department of Internal Medicine, St. Luke's University Hospital Network, 801, Ostrum Street, Bethlehem, Pennsylvania - 18015
USA
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Source of Support: None, Conflict of Interest: None


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We report a 45-year-old African-American female who presented with 20/400 acuity in the right eye and no light perception in the left eye. Based upon a magnetic resonance imaging displaying periventricular white matter enhancement and a lymph node biopsy revealing noncaseating granulomas, we made the diagnosis of neurosarcoidosis which is the only diagnosis that can explain both. Neurosarcoidosis is difficult to diagnose, has high rates of treatment failure, significant morbidity, and 5–10% mortality. We review the differential diagnosis for periventricular white matter and granulomas, presentation of neurosarcoidosis, ocular involvement of neurosarcoidosis, treatment, and patient outcomes. The following core competencies are addressed in this article: Patient care and medical knowledge.


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