Pulmonary and mediastinal “sarcoidosis” following surgical resection of cancer

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• 作者：Edwin Roger Parra ; Mauro Canzian ; Alex ; re Muxfeldt Ab’ ; Saber ; Ricardo Santos Coê ; lho ; Fabiola Gomes Rodrigues ; Ronaldo Adib Kairalla ; Carlos Roberto Ribeiro de Carvalho ; Vera Luiza Capeloz
• 关键词：Sarcoid reaction ; Sarcoidosis ; Hilar and mediastinal enlargement ; Diffuse pulmonary infiltrate ; Sarcoidosis after cancer ; Sarcoidosis mimicking pulmonary metastases
• 刊名：Pathology - Research and Practice
• 出版年：2004
• 出版时间：15 December 2004
• 年：2004
• 卷：200
• 期：10
• 页码：701-705
• 全文大小：525 K

文摘

Previous reports indicate that enlarged hilar and mediastinal lymph nodes caused by sarcoid-like reactions may develop after curative resection of cancer, and their presence does not necessarily denote neoplastic recurrence. Reports further suggest that coexisting pulmonary infiltrates in this setting may be related to sarcoidosis. In this study, we describe two patients who had resected lung and gastric cancer and who later developed pulmonary interstitial infiltrate, concurrent with progressive mediastinal lymphadenopathy initially thought to be caused by intrathoracic dissemination of their cancer. These changes were shown by open lung biopsy to be a benign, granulomatous reaction interpreted as sarcoidosis. Thus, it is important to recognize this clinical pattern when pulmonary infiltrates develop after complete treatment of cancer in an otherwise relapse-free patient and to encourage lung or lymph node biopsy in these particular settings in order to confirm a sarcoid-like reaction, thereby avoiding unnecessary chemotherapy for presumed tumor recurrence.