{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:12:44Z","timestamp":1769724764553,"version":"3.49.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,7,28]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Accumulation of normal lymphocytes within the intradural extramedullary space is rare. To the best of the authors\u2019 knowledge, no prior reports have described a sarcoid-like reaction with lymphoid infiltration arising around the jugular foramen and adhering to cranial nerves. Here, the authors present the case of a tumor-mimicking sarcoid-like reaction with intracranial extension from the left jugular foramen, adherent to the cerebellum, medulla oblongata, and lower cranial nerves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 64-year-old woman with a history of serous otitis media and presumed tuberculous meningitis presented with persistent headache, left-sided tinnitus, hearing loss, hoarseness, and progressive vertigo. Imaging revealed a 2-cm enhancing mass around the left jugular foramen, extending intracranially and adhering to the cerebellum and medulla oblongata. The preoperative differential diagnoses included schwannoma, glomus tumor, meningioma, lymphoma, and granuloma. A retrosigmoid approach was used for biopsy and partial resection. Intraoperative pathology revealed lymphocytic infiltration without malignancy. Definitive pathology confirmed sarcoid-like lymphoid infiltration without evidence of neoplastic or infectious etiology. The patient showed a remarkable response to corticosteroid therapy, with both clinical and radiographic improvement and no recurrence at 20 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Recognition of this rare entity and intraoperative identification of lymphocytic infiltration may support the use of corticosteroids and influence surgical decision-making.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25316\">https:\/\/thejns.org\/doi\/10.3171\/CASE25316<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25316","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T06:32:30Z","timestamp":1753684350000},"source":"Crossref","is-referenced-by-count":0,"title":["Tumor-mimicking sarcoid-like reaction with lymphoid infiltration showing intracranial extension from the left jugular foramen: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Young Ju","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nishi-Kobe Medical Center, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masamitsu","family":"Nishihara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nishi-Kobe Medical Center, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirofumi","family":"Iwahashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Yamanishi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nishi-Kobe Medical Center, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriaki","family":"Ashida","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nishi-Kobe Medical Center, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0419-9497","authenticated-orcid":true,"given":"Kohkichi","family":"Hosoda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Myodani Hospital, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Nagashima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5862-560X","authenticated-orcid":true,"given":"Kazuhiro","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5593-9045","authenticated-orcid":true,"given":"Takashi","family":"Sasayama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"Clin Dermatol","first-page":"326","article-title":"Sarcoidosis and malignancy","volume":"25","author":"Cohen","year":"2007","unstructured":"Cohen PRKurzrock R.Sarcoidosis and malignancy. Clin Dermatol. 2007;25(3):326-333."},{"key":"bib2","series-title":"Front Med (Lausanne)","first-page":"884386","article-title":"Sarcoid-like reaction in patients with malignant tumors: long-term clinical course and outcomes","volume":"9","author":"Huh","year":"2022","unstructured":"Huh JYMoon DSSong JW.Sarcoid-like reaction in patients with malignant tumors: long-term clinical course and outcomes. Front Med (Lausanne). 2022;9:884386."},{"key":"bib3","series-title":"Eur J Cancer","first-page":"18","article-title":"Drug-induced sarcoidosis-like reaction in adjuvant immunotherapy: increased rate and mimicker of metastasis","volume":"131","author":"Chorti","year":"2020","unstructured":"Chorti EKanaki TZimmer LDrug-induced sarcoidosis-like reaction in adjuvant immunotherapy: increased rate and mimicker of metastasis. Eur J Cancer. 2020;131:18-26."},{"issue":"2","key":"bib4","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Jugular foramen tumors: diagnosis and treatment","volume":"17","author":"Ramina","year":"2004","unstructured":"Ramina RManiglia JJFernandes YBJugular foramen tumors: diagnosis and treatment. Neurosurg Focus. 2004;17(2):E5."},{"issue":"1","key":"bib5","series-title":"Insights Imaging","first-page":"29","article-title":"Multimodality imaging of paragangliomas of the head and neck","volume":"10","author":"Thelen","year":"2019","unstructured":"Thelen JBhatt AA.Multimodality imaging of paragangliomas of the head and neck. Insights Imaging. 2019;10(1):29."},{"issue":"8","key":"bib6","series-title":"Laryngoscope","first-page":"1486","article-title":"Jugular foramen schwannomas: diagnosis, management, and outcomes","volume":"115","author":"Wilson","year":"2005","unstructured":"Wilson MAHillman TAWiggins RHShelton C.Jugular foramen schwannomas: diagnosis, management, and outcomes. Laryngoscope. 2005;115(8):1486-1492."},{"issue":"1","key":"bib7","series-title":"Insights Imaging","first-page":"11","article-title":"Dural masses: meningiomas and their mimics","volume":"10","author":"Lyndon","year":"2019","unstructured":"Lyndon DLansley JAEvanson JKrishnan AS.Dural masses: meningiomas and their mimics. Insights Imaging. 2019;10(1):11."},{"key":"bib8","series-title":"Front Neurol","first-page":"901","article-title":"Primary central nervous system lymphomatoid granulomatosis: systematic review","volume":"11","author":"Xiang","year":"2020","unstructured":"Xiang YLiu CXue YPrimary central nervous system lymphomatoid granulomatosis: systematic review. Front Neurol. 2020;11:901."},{"key":"bib9","series-title":"Tuberculosis (Edinb)","first-page":"102016","article-title":"The immunological architecture of granulomatous inflammation in central nervous system tuberculosis","volume":"125","author":"Zaharie","year":"2020","unstructured":"Zaharie SDFranken DJvan der Kuip MThe immunological architecture of granulomatous inflammation in central nervous system tuberculosis. Tuberculosis (Edinb). 2020;125:102016."},{"key":"bib10","series-title":"Front Immunol","first-page":"292","article-title":"Follicular dendritic cells in health and disease","volume":"3","author":"El Shikh","year":"2012","unstructured":"El Shikh MEPitzalis C.Follicular dendritic cells in health and disease. Front Immunol. 2012;3:292."},{"issue":"6","key":"bib11","series-title":"Trends Mol Med","first-page":"509","article-title":"Tertiary lymphoid structures in the central nervous system","volume":"31","author":"Yang","year":"2025","unstructured":"Yang CCai YXWang ZFTian SFLi ZQ.Tertiary lymphoid structures in the central nervous system. Trends Mol Med. 2025;31(6):509-521."},{"issue":"3","key":"bib1","series-title":"Clin Dermatol","first-page":"326","article-title":"Sarcoidosis and malignancy","volume":"25","author":"Cohen","year":"2007","unstructured":"Cohen PRKurzrock R.Sarcoidosis and malignancy. Clin Dermatol. 2007;25(3):326-333."},{"key":"bib2","series-title":"Front Med (Lausanne)","first-page":"884386","article-title":"Sarcoid-like reaction in patients with malignant tumors: long-term clinical course and outcomes","volume":"9","author":"Huh","year":"2022","unstructured":"Huh JYMoon DSSong JW.Sarcoid-like reaction in patients with malignant tumors: long-term clinical course and outcomes. Front Med (Lausanne). 2022;9:884386."},{"key":"bib3","series-title":"Eur J Cancer","first-page":"18","article-title":"Drug-induced sarcoidosis-like reaction in adjuvant immunotherapy: increased rate and mimicker of metastasis","volume":"131","author":"Chorti","year":"2020","unstructured":"Chorti EKanaki TZimmer LDrug-induced sarcoidosis-like reaction in adjuvant immunotherapy: increased rate and mimicker of metastasis. Eur J Cancer. 2020;131:18-26."},{"issue":"2","key":"bib4","series-title":"Neurosurg Focus","first-page":"E5","article-title":"Jugular foramen tumors: diagnosis and treatment","volume":"17","author":"Ramina","year":"2004","unstructured":"Ramina RManiglia JJFernandes YBJugular foramen tumors: diagnosis and treatment. Neurosurg Focus. 2004;17(2):E5."},{"issue":"1","key":"bib5","series-title":"Insights Imaging","first-page":"29","article-title":"Multimodality imaging of paragangliomas of the head and neck","volume":"10","author":"Thelen","year":"2019","unstructured":"Thelen JBhatt AA.Multimodality imaging of paragangliomas of the head and neck. Insights Imaging. 2019;10(1):29."},{"issue":"8","key":"bib6","series-title":"Laryngoscope","first-page":"1486","article-title":"Jugular foramen schwannomas: diagnosis, management, and outcomes","volume":"115","author":"Wilson","year":"2005","unstructured":"Wilson MAHillman TAWiggins RHShelton C.Jugular foramen schwannomas: diagnosis, management, and outcomes. Laryngoscope. 2005;115(8):1486-1492."},{"issue":"1","key":"bib7","series-title":"Insights Imaging","first-page":"11","article-title":"Dural masses: meningiomas and their mimics","volume":"10","author":"Lyndon","year":"2019","unstructured":"Lyndon DLansley JAEvanson JKrishnan AS.Dural masses: meningiomas and their mimics. Insights Imaging. 2019;10(1):11."},{"key":"bib8","series-title":"Front Neurol","first-page":"901","article-title":"Primary central nervous system lymphomatoid granulomatosis: systematic review","volume":"11","author":"Xiang","year":"2020","unstructured":"Xiang YLiu CXue YPrimary central nervous system lymphomatoid granulomatosis: systematic review. Front Neurol. 2020;11:901."},{"key":"bib9","series-title":"Tuberculosis (Edinb)","first-page":"102016","article-title":"The immunological architecture of granulomatous inflammation in central nervous system tuberculosis","volume":"125","author":"Zaharie","year":"2020","unstructured":"Zaharie SDFranken DJvan der Kuip MThe immunological architecture of granulomatous inflammation in central nervous system tuberculosis. Tuberculosis (Edinb). 2020;125:102016."},{"key":"bib10","series-title":"Front Immunol","first-page":"292","article-title":"Follicular dendritic cells in health and disease","volume":"3","author":"El Shikh","year":"2012","unstructured":"El Shikh MEPitzalis C.Follicular dendritic cells in health and disease. Front Immunol. 2012;3:292."},{"issue":"6","key":"bib11","series-title":"Trends Mol Med","first-page":"509","article-title":"Tertiary lymphoid structures in the central nervous system","volume":"31","author":"Yang","year":"2025","unstructured":"Yang CCai YXWang ZFTian SFLi ZQ.Tertiary lymphoid structures in the central nervous system. Trends Mol Med. 2025;31(6):509-521."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/4\/article-CASE25316.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/4\/article-CASE25316.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/4\/article-CASE25316.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:11:07Z","timestamp":1769685067000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/4\/article-CASE25316.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":22,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/case25316","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,28]]}}}