Sarcoid reactions in primary pulmonary carcinoma: report of seven cases.

Kamiyoshihara, Mitsuhiro; Hirai, Toshikazu; Kawashima, Osamu; Ishikawa, S; Morishita, Yasuo

doi:10.3892/or.5.1.177

Cited by 47 publications

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“…However, several authors reported that among lung cancer patients this disease was not associated with any histological type, while others reported the adenocarcinoma type was more frequent. Kamiyoshihara et al reported that the relative incidence of the various histological types varied greatly between countries or races even in cases of small cell lung cancer with sarcoid reactions (10). In our series where various histological types of lung cancer were observed, it was suggested that no histological type is etiologically associated.…”

Section: Discussionmentioning

confidence: 43%

“…With regard to lung cancer with sarcoid reactions, there have been few reports, however (9,10). Kamiyoshihara et al reported seven cases of primary pulmonary carcinoma with sarcoid reactions, and concluded that the sarcoid reaction did not influence the prognosis of lung cancer (10). In this study, four patients (18%) were classified as having node metastasis and eight (36%) were in advanced-stage disease.…”

Section: Discussionmentioning

confidence: 48%

“…For example, the incidence of sarcoid reaction was reported to be 0.93% in patients with Hodgkin's disease by Brincker et al and 2.2% in patients with breast cancer by Giunti et al (7,8). However, the incidence of this disease associated with lung cancer was reported to be 2.2-3.2% (9,10). In this study reviewing 1733 lung cancer patients, the incidence was 1.3%.…”

Section: Discussionmentioning

confidence: 63%

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Surgical Results of Lung Cancer with Sarcoid Reaction in Regional Lymph Nodes

Tomimaru¹,

Higashiyama²,

Okami³

et al. 2007

Japanese Journal of Clinical Oncology

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Background: There have been few reports of sarcoid reaction in the regional lymph nodes associated with lung cancer. The purpose of this study was to analyze the surgical results of lung cancer with sarcoid reaction. Methods: Of 1733 lung cancer patients undergoing surgical treatment in our institute from 1990 to 2004, we reviewed 22 patients (1.3%) with sarcoid reaction in the regional lymph nodes of lung cancer. Results: On pre-operative computed tomography (CT), mediastinal lymph node swelling was detected in 19 patients (86%) as clinical N3 disease (c-N3) in six or as c-N2 in 13, while three patients were classified as c-N0. To these 19 patients, lymph node status was histologically checked by mediastinoscopy in four patients, sternotomy approach in two and open mini-thoracotomy in 13. Because the sampling-biopsy nodes showed no tumor metastasis, radical surgery was promptly performed. However, four patients (18%) were finally judged to have pathological lymph node positive disease. Five patients were in pathological stage (pstage) IA, nine in p-stage IB, five in p-stage IIB, two in p-stage IIIA, and one in stage IIIB. The overall 3-, and 5-year survival rates of these patients were 85.2 and 77.7%, respectively, with no significant difference compared to those of the remaining patients without sarcoid reaction. Conclusions: Because lung cancer patients with sarcoid reaction in the regional lymph nodes frequently show mediastinal lymph node swelling on CT, radical resection should be performed after confirming the node status by appropriate sampling biopsy. It seems that surgical results of lung cancers with sarcoid reaction in the regional nodes are not prognostically different from those without sarcoid reaction.

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Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 63%

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Surgical Results of Lung Cancer with Sarcoid Reaction in Regional Lymph Nodes

Tomimaru¹,

Higashiyama²,

Okami³

et al. 2007

Japanese Journal of Clinical Oncology

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“…Kamiyoshihara i wsp. na podstawie własnych obserwacji również wywnioskowali, że odczyn sarkoidalny nie ma wpływu na rokowanie chorych na nowotwory płuc [8].…”

Section: Omówienieunclassified

Fałszywie dodatni wynik badania 18F-FDG PET u pacjenta chorego na raka płuca spowodowany odczynem sarkoidalnym w regionalnych węzłach chłonnych

Kuś¹,

Gabryś²,

Czyżewski

2014

Advances in Respiratory Medicine

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Rozwój nieserowaciejących ziarniniaków u pacjentów chorych na nowotwory traktuje się jako odczyn sarkoidalny. Powstaje on w guzie lub jego sąsiedztwie, najczęściej jednak w regionalnych węzłach chłonnych i zwykle zanika po wyleczeniu choroby zasadniczej. Patogeneza tego zjawiska nie została w pełni wyjaśniona. Według doniesień, częstość występowania odczynu sarkoidalnego u pacjentów chorych na raka płuca wynosi 1.3−3.2% a nieserowaciejące ziarniniaki są stwierdzane przede wszystkim w węzłach chłonnych śródpiersia i wnękowych.Węzły chłonne powiększone w wyniku reakcji sarkoidalnej upodabniają się do limfadenopatii o etiologii nowotworowej i taki obraz radiologiczny może stwarzać trudności diagnostyczne. W pracy zaprezentowano historię choroby pacjenta z odczynem sarkoidalnym w regionalnych węzłach chłonnych w przebiegu raka płuca i związanych z tym trudności interpretacyjnych badania pozytonowej tomografii emisyjnej (18F-FDG PET), które mogły doprowadzić do niewłaściwego leczenia. Nieprawidłowe gromadzenie radioznacznika fluorodeoxyglukozy (FDG) w węzłach chłonnych śródpiersia i wnękowych u pacjenta po wcześniejszej chemioterapii neoadjuwantowej i prawostronnej pneumonektomii, w opinii radiologów, jednoznacznie wskazywało na progresję choroby nowotworowej. Uwzględniając dobry stan kliniczny pacjenta oraz rozpoznanie nieserowaciejących ziarniniaków w badaniu histologicznym usuniętych węzłów chłonnych, zdecydowano o poszerzeniu diagnostyki. Chory nie wyraził zgody na mediastinoskopię, dlatego wykonano przezoskrzelową biopsję aspiracyjną pod kontrolą ultrasonografii (EBUS-TBNA). W materiale cytologicznym, uzyskanym z biopsji węzłów chłonnych, nie znaleziono komórek nowotworowych, natomiast stwierdzono ziarninę sarkoidalną. Na podstawie całości obrazu klinicznego, radiologicznego oraz wyników badania cytologicznego i histologicznego wysunięto wniosek, że wzmożony wychwyt FDG w węzłach chłonnych był spowodowany odczynem sarkoidalnym, a nie procesem nowotworowym. Odstąpiono od podania chemioterapii II linii. Pacjent pozostaje w fazie obserwacji.

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“…The involvement of mediastinal lymph nodes is common in both and makes the diagnosis challenging when these conditions coexist. Besides, lung cancers by itself can cause a granulomatous reaction in lymph nodes without metastasis [2], further complicating the clinical picture. We report a rare case of a patient with history of sarcoidosis who was diagnosed with small cell lung cancer, creating a diagnostic dilemma with …”

Section: Introductionmentioning

confidence: 99%

Lung cancer or sarcoidosis: A diagnostic dilemma

Ramadas¹,

Krishnan²,

Pandita³

et al. 2016

J Cancer Ther Res

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Background: Small cell lung cancer is a neuroendocrine neoplasm representing about 15 percent of all lung cancers. Sarcoidosis is a multisystem granulomatous disease. The involvement of mediastinal lymph nodes is common in both and makes the diagnosis challenging when these conditions coexist. We report a rare case of a patient with history of sarcoidosis who was diagnosed with small cell lung cancer. Case presentation: 65-year-old African American female with history of sarcoidosis, who presented with right sided shoulder pain for two months. CT thorax showed right upper lobe nodule with mediastinal and bilateral hilar lymphadenopathy. FDG-PET scan showed increased uptake in the right upper lobe and in mediastinal and hilar lymph nodes. She subsequently underwent an EBUS with biopsies of multiple lymph node stations. Pathology of these lymph nodes revealed non-necrotizing granulomas without evidence of malignancy. She underwent a CT guided biopsy of the right upper lobe lesion and pathology was consistent with small cell carcinoma. It was unclear whether the enlarged and active mediastinal and hilar lymph nodes were related to sarcoidosis or small cell cancer. A multidisciplinary meeting was conducted and decided to treat the patient presumably as small cell cancer with nodal disease. She was given 2 cycles of carboplatin and etoposide. Follow-up CT thorax after the second cycle showed decrease in size of the nodule along with mediastinal and hilar lymph nodes. She also underwent radiation therapy including mediastinum in the field of radiation. Discussion: Sarcoid-like reactions have been noted either in the vicinity of the tumor or within the regional lymph nodes draining that particular tumor. This has been described in less than 1 percent of lung cancers and mostly in squamous cell lung cancers. True sarcoidosis may be confused with a sarcoid-like reaction in cancer patients. It was not possible to definitively differentiate if the nodal involvement was from sarcoidosis or small cell cancer metastasis or a sarcoid like reaction in our patient. Given the diagnostic dilemma, we treated her nodal involvement as small cell lung cancer metastasis since under treatment could lead to relapse and compromise survival.

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Sarcoid reactions in primary pulmonary carcinoma: report of seven cases.

Cited by 47 publications

References 0 publications

Surgical Results of Lung Cancer with Sarcoid Reaction in Regional Lymph Nodes

Surgical Results of Lung Cancer with Sarcoid Reaction in Regional Lymph Nodes

Fałszywie dodatni wynik badania 18F-FDG PET u pacjenta chorego na raka płuca spowodowany odczynem sarkoidalnym w regionalnych węzłach chłonnych

Lung cancer or sarcoidosis: A diagnostic dilemma

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