Diffuse leptomeningeal enhancement in neurosarcoidosis-related longitudinally extensive myelitis

A 35-year-old man presented with a 1-month history of bilateral lower limb weakness and numbness. On examination, he had paraparesis with lower limbs hyperreflexia, and T5 sensory level. Magnetic resonance imaging (MRI) of the spine revealed a longitudinally extensive myelitis (LETM) with a diffuse leptomeningeal enhancement ([Figure 1]). Thorax computed tomography (CT) disclosed bilateral hilar lymphadenopathy. A transbronchial lymph node fine-needle biopsy revealed noncaseating granulomas. Considering this finding, probable neurosarcoidosis was diagnosed.