Pulmonary sarcoidosis masquerading as metastatic cervical cancer: a pitfall in CT scans and positron emission tomography (PET)

Rubasingham, J.; Marzouk, Sherief; Madhavan, Krishnaswamy; Sioftanos, George; Liyanage, Sidath H.

doi:10.1259/bjrcr.20190125

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…On contrary, in another cross-registry study of 555 danish sarcoidosis patients, no increase incidence of malignancy is found, although this might slightly be due to lack of power [54]. Although breast, thyroid cancers are the most common [11] sarcoidosis coexisting with various other cancers were reported in the literature [55].…”

Section: Malignancies Coexisting With Sarcoidosismentioning

confidence: 86%

“…Bala et al reported a case of testicular sarcoidosis mimicking as testicular malignancy in a 49-year-old Indian male who also has coexisting PTC [58]. Although rare, a case of cervical cancer in a 31-year-old female presenting as cervical fungating polyp with thoracic lymphadenopathy and without pelvic and para-aortic lymph node involvement which on further workup confirmed sarcoidosis coexistence [55]. In conclusion, whenever a lymph node pattern that is not in correlation with the cancer is seen, diagnostic uncertainty arises.…”

Section: Sarcoidosis With Other Cancersmentioning

confidence: 97%

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Sarcoidosis: Various Presentations, Coexisting Diseases and Malignancies

Gaddam¹,

Ojinnaka²,

Ahmed³

et al. 2021

Cureus

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Sarcoidosis is a rare, chronic inflammatory disease with a characteristic non-caseating granuloma formation. It affects women more than men. The lung is the most commonly affected organ, however, extrapulmonary involvement is also seen. Sarcoidosis can affect any organ or tissue and can also involve multiple organs simultaneously. As a disease, it shares clinical symptoms with a variety of autoimmune, non-autoimmune disorders and malignancies. Not only it mimics clinically, but it also coexists with these diseases, posing a significant diagnostic challenge. During this literature review, we obtained data from the previously published PubMed articles within the last five years and reviewed the possible etiological association and clinical coexistence between sarcoidosis and other diseases/malignancies. We aimed to determine the common clinical manifestations, various complex presentations of sarcoidosis and pathophysiological considerations for the association, and to emphasize the link with other diseases, particularly thyroid disorders/malignancies. Physicians should be aware of these associated diseases and should always make a clinical suspicion when confronting a sarcoidosis patient. Thus, a comprehensive diagnostic evaluation for these associated conditions ought to be done in sarcoidosis patients to avoid any delay in the curative treatment for these coexisting diseases and to prevent substandard outcomes.

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Section: Malignancies Coexisting With Sarcoidosismentioning

confidence: 86%

Section: Sarcoidosis With Other Cancersmentioning

confidence: 97%

Sarcoidosis: Various Presentations, Coexisting Diseases and Malignancies

Gaddam¹,

Ojinnaka²,

Ahmed³

et al. 2021

Cureus

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show abstract

“…[ 20 ] However, this mode of participation is not specific and can be found in Hodgkin’s lymphoma, especially the nodularsclerosis type. [ 21 , 22 ] In addition, parenchymal presentations and the age at onset of both also overlap. Moreover, the treatments of sarcoidosis and Hodgkin’s lymphoma are very different.…”

Section: Discussionmentioning

confidence: 99%

Value of CT spectral imaging in the differential diagnosis of sarcoidosis and Hodgkin’s lymphoma based on mediastinal enlarged lymph node: A STARD compliant article

Cao

Liu

2022

Medicine

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To investigate the imaging characteristics of sarcoidosis and Hodgkin's lymphoma based on mediastinal enlarged lymph node using spectral CT and evaluate whether the quantitative information can improve the differential diagnosis of these diseases. This retrospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Overall, 21 patients with sarcoidosis and 39 patients with Hodgkin's lymphoma were examined with CT spectral imaging during the arterial phase (AP) and venous phase (VP). The CT values on 40 to 140 keV monochromatic images and iodine (water) concentrations of enlarged lymph nodes were obtained in AP and VP. Iodine concentrations (ICs) were normalized to the iodine concentration in the aorta. The differences in normalized iodine concentrations (NICs) and hounsfield units (HU) curve slop (λ HU ) were calculated. Anatomical distribution of mediastinal lymph nodes and morphologic features were also compared. Receiver operating characteristic curves were generated to help establish threshold values for the parameters required for the significant differentiation of sarcoidosis from lymphomas. The CT values on 40 to 100 keV monochromatic images in AP and 40 to 50 keV in VP were higher in sarcoidosis than those in Hodgkin's lymphoma, the differences were statistically significant (P < .05); NICs during the AP and λ HU during the AP (VP) in patients with sarcoidosis differed significantly from those in patients with Hodgkin's lymphoma. Receiver operating characteristic curves analysis showed that the monochromatic CT value on 40 keV in AP had the highest sensitivity (71.4%) and specificity (100%) in differentiating sarcoidosis from Hodgkin's lymphoma. The anatomic distribution, coalescence, calcification, compression, enhancement pattern and enhancement degree of the mediastinal enlarged lymph node differed significantly between the groups (P < .05). The combination of monochromatic CT value, NICs and λ HU had higher sensitivity and specificity than did those of conventional qualitative CT image analysis during the combined phases. CT spectral imaging has promising potential for the diagnostic differentiation of Hodgkin's lymphomas and sarcoidosis. The monochromatic CT value, iodine content and λ HU could be valuable parameters for differentiating Hodgkin's lymphomas and sarcoidosis based on mediastinal enlarged lymph node.Abbreviations: AP = arterial phase, HU = hounsfield units, ICs = iodine concentrations, NICs = normalized iodine concentrations, ROI = region of interest, VP = venous phase, λ HU = HU curve slop.

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Pulmonary sarcoidosis masquerading as metastatic cervical cancer: a pitfall in CT scans and positron emission tomography (PET)

Cited by 2 publications

References 13 publications

Sarcoidosis: Various Presentations, Coexisting Diseases and Malignancies

Sarcoidosis: Various Presentations, Coexisting Diseases and Malignancies

Value of CT spectral imaging in the differential diagnosis of sarcoidosis and Hodgkin’s lymphoma based on mediastinal enlarged lymph node: A STARD compliant article

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