The Concurrence of Granulomatous Inflammation in Intrathoracic Lymph Nodes with Regional Metastasis from Primary Lung Cancer in Surgically Resected Specimens

Krvavac, Armin; Munzer, Kurt; Miller, Aaron W.; Poddar, Nishant; Jamkhana, Zafar; Patolia, Setu

doi:10.5603/arm.2018.0034

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…In our study infectious disease was found in 16 patients, most of them due to tuberculous infection. At the same time, as other authors have also reported, potentially fatal diseases such as a malignancy can also occur [18][19][20]. In the present series, neoplasms were detected in 12 patients.…”

Section: Characteristic (N=207)supporting

confidence: 82%

The importance of non-necrotising granulomatosis

Alende-Castro¹,

Sopeña²,

Cameselle-Teijeiro³

et al. 2019

J Histol Histopathol

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Objective: The diagnosis of non-necrotising granulomatosis (NNG) is very frequent in clinical practice. There are few studies, however, within the spectrum of pathologies that cause NNG; consequently, except for sarcoidosis, little information is available. The objective is to determine the prevalence of sarcoidosis, autoimmune diseases and other entities in NNG. Methods: We collected all pathological reports with a diagnosis of non-necrotising granulomatosis from 1 January 2010 to 31 December 2014 in the Clinical University Hospital of Santiago de Compostela, Spain. Results: A total of 290 tissue samples from 207 patients were reviewed. Of these patients, 50.7% were women, with a mean age of 51.2 years. The origins of the samples were: skin 32.9%, lymph nodes 26.6%, transbronchial biopsy 14.5%, lung 5.8% and others 20.2%. Final diagnoses were: sarcoidosis 59.9%; infectious diseases 7.7%, including tuberculosis 4.0% and non-tuberculous mycobacterial infection 1.4%; foreign body granulomatosis 6.3%; neoplasms 5.9%; autoimmune disease 3.1% and others 4.0%. A diagnosis was not determined in 5.9% patients. Conclusion: The prevalence of sarcoidosis in NNG is over 50%, while autoimmune disease prevalence is considerably lower (3.1%), with Wegener granulomatosis being the most commonly reported. The most frequent alternative diagnosis was infectious disease, mainly tuberculosis.

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Section: Characteristic (N=207)supporting

confidence: 82%

The importance of non-necrotising granulomatosis

Alende-Castro¹,

Sopeña²,

Cameselle-Teijeiro³

et al. 2019

J Histol Histopathol

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<p>Enlarged Mediastinal Lymph Nodes in Computed Tomography are a Valuable Prognostic Factor in Non-Small Cell Lung Cancer Patients with Pathologically Negative Lymph Nodes</p>

Zheng¹,

Huang²,

Bi³

et al. 2020

CMAR

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Background Most non-small cell lung cancer patients with enlarged mediastinal lymph nodes (LN) in preoperative computer tomography (CT) images are diagnosed with N0 in the pathological examination after surgery. However, these patients seem to have worse survival than those without enlarged mediastinal LN in our clinical practice. This study aimed to investigate whether the size of mediastinal LN is correlated with the prognosis in pathological N0 patients, which could help us to predict the prognoses further. Methods The retrospective cohort study involved 758 N0 patients with a thin layer CT scan. We have measured the size of mediastinal LN, including long diameter, short diameter, and volume on CT image, and classified patients by X-tile. Next, we explored the risk factors of enlarged LN by univariate and multivariate logistic analysis. Then, we have compared the 5-year cancer-specific survival by Kaplan–Meier and log-rank method. Multivariate Cox analysis was utilized to further survival analysis. Finally, we have constructed the prediction model by nomogram. Results A total of 150 N0 patients (19.8%) had mediastinal LN enlargement in our study. After multivariate logistic analysis, we found the LN enlargement was significantly correlated with age (p=0.001), pathology (p < 0.001) and tumor recurrence (p < 0.001). The patients with LN enlargement had a worse 5-year cancer-specific survival (75.3% vs 92.8%, p < 0.001) after Kaplan–Meier analysis. Patients with a larger volume had increased risk of tumor-associated death when compared with the normal group (p < 0.001) by multivariate Cox analyses. Conclusion N0 patients with larger mediastinal LN had a worse 5-year cancer-specific survival and a higher risk of recurrence. The volume of LN was the most valuable prognostic factor in N0 patients.

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Granulomas co-occurring in malignancies – tale of etiological relationship

Babuta,

Garg,

Vinayakamurthy

et al. 2024

ANAMS

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Objectives To determine the possible aetiopathogenesis of co-occurrence of granulomas with different malignancies in different body sites. Material and methods All cases with granuloma formation observed in draining lymph nodes or in the primary site of malignant tumors were included in the present study. After routine histopathology examination, modified Ziehl-Neelsen (ZN) staining for Mycobacteria was carried out in all the cases. Detailed history, especially of Tuberculosis, sarcoidosis, neoadjuvant chemotherapy, radiation, or previous procedure, was recorded. Results 11 out of 35 cases (31.4%) had granulomas within the primary tumor, while 24 cases out of 35 (68.6%) showed nodal granulomas. Of the 24 cases, 5 cases had nodal metastatic tumor deposits. Also, necrotizing granulomas with AFB were significantly more as compared to AFB in non-necrotizing granulomas (p value of 0.05). Of the total cases, 20% had an attributed risk factor. Three cases received neoadjuvant chemotherapy, and three had a history of systemic tuberculosis, while one case had associated Crohn’s disease. Conclusion We recommend to characterize granulomas as necrotizing/nonnecrotizing, confluent/discrete, tumor deposit present/absent; prior history of systemic/local illnesses (like SS, TB, fungal infections, IBD, etc.); prior history of CT/RT; and to follow routine ZN staining in all cases of granulomas with malignancy.

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The Concurrence of Granulomatous Inflammation in Intrathoracic Lymph Nodes with Regional Metastasis from Primary Lung Cancer in Surgically Resected Specimens

Cited by 3 publications

References 21 publications

The importance of non-necrotising granulomatosis

The importance of non-necrotising granulomatosis

<p>Enlarged Mediastinal Lymph Nodes in Computed Tomography are a Valuable Prognostic Factor in Non-Small Cell Lung Cancer Patients with Pathologically Negative Lymph Nodes</p>

Granulomas co-occurring in malignancies – tale of etiological relationship

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