Purpose of Review

Neurosarcoidosis is a rare manifestation of sarcoidosis that is challenging to diagnose. Biopsy confirmation of granulomas is not sufficient, as other granulomatous diseases can present similarly. This review is intended to guide the clinician in identifying key conditions to exclude prior to concluding a diagnosis of neurosarcoidosis.

Recent Findings

Although new biomarkers are being studied, there are no reliable tests for neurosarcoidosis. Advances in serum testing and imaging have improved the diagnosis for key mimics of neurosarcoidosis in certain clinical scenarios, but biopsy remains an important method of differentiation.

Summary

Key mimics of neurosarcoidosis in all cases include infections (tuberculosis, fungal), autoimmune disease (vasculitis, IgG4-related disease), and lymphoma. As neurosarcoidosis can affect any part of the nervous system, patients should have a unique differential diagnosis tailored to their clinical presentation. Although biopsy can assist with excluding mimics, diagnosis is ultimately clinical.

中文翻译：

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神经结节病：诊断挑战和模拟综述

审查目的

神经结节病是结节病的一种罕见表现，诊断起来很困难。肉芽肿的活检证实是不够的，因为其他肉芽肿疾病也可能出现类似的情况。本综述旨在指导临床医生在做出神经结节病诊断之前确定需要排除的关键条件。

最近的发现

尽管正在研究新的生物标志物，但尚无可靠的神经结节病测试方法。血清检测和影像学的进步改善了某些临床情况下神经结节病关键模拟疾病的诊断，但活检仍然是重要的鉴别方法。

概括

所有病例中神经结节病的主要症状包括感染（结核、真菌）、自身免疫性疾病（血管炎、IgG4 相关疾病）和淋巴瘤。由于神经结节病可以影响神经系统的任​​何部分，因此患者应该根据其临床表现进行独特的鉴别诊断。尽管活检可以帮助排除拟态，但诊断最终是临床的。