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Clinical Problems in Cardiopulmonary Disease |

Sarcoidosis Involving Multiple Systems*: Diagnostic and Therapeutic Challenges

Eric S. White, MD; Joseph P. Lynch, III, MD, FCCP
Author and Funding Information

*From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI.

Correspondence to: Joseph P. Lynch, III, MD, FCCP, Professor of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical Center, 3916 Taubman Center, Box 0360, Ann Arbor, MI 48109-0360



Chest. 2001;119(5):1593-1597. doi:10.1378/chest.119.5.1593
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Extract

A 39 -year-old black man presented initially at an outside facility with diplopia and pain over the left eye. He also had numbness in his right leg. Except for a strong family history of coronary disease, his history and the system review were negative. Physical examination disclosed paralysis with hypalgesia in the distribution of the right fourth lumbar nerve root. No adenopathy was detected. An MRI scan of the brain displayed a mass lesion involving the left anterior clinoid and left cavernous sinus. A 67Ga scan disclosed increased uptake in this area. An MRI scan of the spine was said to have displayed contrast “enhancement” of several nerve roots. Spinal fluid obtained by lumbar puncture contained a slight elevation of protein and 46 lymphocytes/mm2; cytologic examination disclosed no evidence of malignant cells. Measurement of serum angiotensin-converting enzymes (ACEs) showed normal levels. A chest roentgenogram was normal, displaying no infiltrates or adenopathy.

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