Diffuse spine involvement in sarcoidosis with sternal lytic lesions

Study Design. Case report. Objective. To report 2 cases of sarcoidosis with a diffuse vertebral involvement, associated with a rare location in the sternum. Summary of Background Data. Sarcoidosis is a systemic disease of unknown cause with various clinical and radiologic manifestations. Bone involvement is rare (1% 13% of cases). Vertebral involvement is very uncommon. Lytic lesions, sclerotic lesions, or both of these patterns may be observed. Methods. One patient complained of diffuse bone pain; the second patient was asymptomatic. Each patient had radiograph, CT, and MRI of the spine. The second patient also underwent a PET/CT FDG-(18F). Sternal bone biopsy was performed in both patients. Pathologic findings indicated typical pattern of bone sarcoidosis. Clinical and biologic improvement was noticed after treatment with corticosteroids. Results. In our 2 cases, radiograph, CT, MRI, and PET/CT findings were evocative of diffuse spine involvement in sarcoidosis associated with sternal lytic lesions. This suspicion was confirmed by histopathologic findings, which found a typical pattern of sarcoidosis. Conclusion. These 2 cases emphasize the value of CT, MRI, and FDG-(18F) PET/CT for the diagnosis of diffuse spinal involvement in sarcoidosis and describe an exceptional association with sternal lytic lesions.