Multiple early gastric cancer associated with sarcoid-like reaction in the regional lymph nodes

Nakamura, Masayuki; Mizuta, Eishi; Morioka, H; Nakamura, Mitsuo; Isiglo, Kimio

doi:10.1007/s005350170036

Cited by 13 publications

(8 citation statements)

References 16 publications

(21 reference statements)

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“…6,8,9,13-15,21,23,33,45-56 , 5,7,10-12,16-20,22,24,25,27-32,34-44,59 Most often, these reactions are observed in lymph nodes draining the malignancy but can also occur in distant organs or the tumor-affected organ itself. [5][6][7][10][11][12][16][17][18][19][20]22,24,25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]46,47,59 The mechanism for sarcoidlike reactions remains unknown. 46 Some authors have suggested a T-cell-mediated host response to soluble tumor antigens and others a reaction to tumor cell metabolites.…”

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confidence: 99%

Paraneoplastic Sarcoid-Like Reactions and the Eye

Balasubramaniam

Salomão

Davies

et al. 2015

Retina

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confidence: 99%

Paraneoplastic Sarcoid-Like Reactions and the Eye

Balasubramaniam

Salomão

Davies

et al. 2015

Retina

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“…There have been no definitive reports about the relationships among pathogeneses of systemic sarcoidosis, sarcoid reactions associated with malignancy, and drug-induced sarcoid reactions. Favorable outcomes of advanced gastric cancer patients with sarcoid reactions and the possibility of the active involvement of the host immune system against tumors have been reported for some time [ 4 , 15 ]. Chopra et al reported the necessity to distinguish sarcoid reactions associated with malignancy from drug-induced sarcoid reactions [ 12 ], but the investigation into the pathophysiologic mechanisms of immunotherapy-related sarcoid reactions might contribute to elucidating the immunopathologic mechanisms of sarcoid reactions associated with cancers.…”

Section: Discussionmentioning

confidence: 99%

“…Nakamura et al reported that because sarcoid reactions in resected lymph nodes represent a relatively ordinary phenomenon in gastric cancer, pathologists may not always report these small granulomas or may downplay them [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Splenic sarcoid reaction mimicking metachronous metastasis in patients after distal gastrectomy for gastric cancer: a case report and literature review

et al. 2020

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Background The occurrence of sarcoid reactions has been recognized in various cancers. The common location for observing these granulomas is mainly the lymph nodes, but a rare occurrence in the spleen has been reported. Almost all splenic sarcoid reactions associated with gastric cancer have been resected synchronously and diagnosed accidentally, and a rare metachronous occurrence of a sarcoid reaction in the spleen after distal gastrectomy can mimic cancer metastasis. We describe a rare case of a splenic sarcoid reaction recognized in a patient with gastric cancer 6 months after distal gastrectomy. Case presentation An 82-year-old man underwent laparoscopic distal gastrectomy for gastric cancer (T3N0M0, stage IIA). Six months after gastrectomy, CT and 18F-fluorodeoxyglucose (FDG)-PET/CT showed the appearance of a splenic mass. We diagnosed solitary splenic metastasis from gastric cancer and performed laparoscopic-assisted splenectomy. His splenic tumor was diagnosed as a sarcoid reaction by histopathological examination. Conclusion To our knowledge, this is the first report of a splenic sarcoid reaction recognized 6 months after distal gastrectomy for gastric cancer without any chemotherapy. The splenic sarcoid reaction and cancer metastasis to the spleen were undistinguishable from the CT and FDG-PET/CT findings. The present case and literature review showed that cases of splenic sarcoid reactions associated with gastric cancer can also be accompanied by the occurrence of these granulomas in lymph nodes. When the appearance of a solitary mass is observed in the spleen after resection of primary cancer, it is necessary to consider not only cancer metastasis but also sarcoid reactions. Retrospective histopathological confirmation of the existence of sarcoid reactions in lymph nodes from resected specimens might possibly avoid incorrect diagnosis and intervention.

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“…Several studies have shown that the presence of granulomas in Hodgkin's disease correlated with improved survival in all stages of disease [15][16][17]. Similarly, SL reactions in gastric carcinoma have been reported to have a good prognosis [18]. Takeuchi et al demonstrated that the incidence of SL reactions in the regional lymph nodes decreased as gastric cancer progressed [19].…”

Section: Prognostic Significancementioning

confidence: 99%

Sarcoid Granulomas in Malignancy

Arora¹,

Kaur²,

Ro³

2020

Sarcoidosis and Granulomatosis - Diagnosis and Management

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Noncaseating epithelioid granulomas without accompanying systemic symptoms of sarcoidosis have been described in association with many primary tumors where they are designated as sarcoid-like (SL) reaction. Morphologically, this SL reaction is similar to granulomas found in systemic sarcoidosis comprising of focal accumulation of epithelioid cells and multinucleated giant cells. They can be seen either adjacent to the primary malignancy or in local draining lymph nodes. Additionally, sarcoid-like granulomas can affect other organs distant from the primary neoplasm, such as the spleen, bone marrow, and skin. This sarcoid-like reaction is thought to occur as an immunologic T-cell-mediated response to antigens expressed by the neoplastic cells or soluble tumor antigens. Whether the presence of this sarcoid-like reaction has any prognostic significance in the associated neoplasm is unclear.

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Multiple early gastric cancer associated with sarcoid-like reaction in the regional lymph nodes

Cited by 13 publications

References 16 publications

Paraneoplastic Sarcoid-Like Reactions and the Eye

Paraneoplastic Sarcoid-Like Reactions and the Eye

Splenic sarcoid reaction mimicking metachronous metastasis in patients after distal gastrectomy for gastric cancer: a case report and literature review

Sarcoid Granulomas in Malignancy

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