A biopsy of the mediastinal lymph nodes was conducted. It showed lymphatic tissue with fragments of granulomas without necrosis but sclerosis due to sarcoidosis.
Bronchoalveolar lavage showed an elevated number of lymphocytes with a high T4/T8 quotient of 11 (normal 1,5-3,5) as part of lymphocytic alveolitis due to sarcoidosis with lung involvement.
CSF / liquor showed elevated lymphocytes in line with nonbacterial meningitis.
This case highlights an isolated spinal involvement in neurosarcoidosis with longitudinal myelitis. The epididymitis was probably the first clinical manifestation of the systemic sarcoidosis. The patient was treated with steroids, the symptoms decreased within a few days.