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Sarcoidlike reaction in patients with malignancy
A R Hunsaker1, R F Munden, R D Pugatch
1Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Radiology
|July 1, 1996
Summary
Sarcoidlike reaction, characterized by noncaseating granulomas (NCG), can mimic metastatic disease in cancer patients. Careful histopathologic sampling is crucial for accurate diagnosis and prognosis.
Area of Science:
- Pulmonary Medicine
- Oncology
- Radiology
Background:
- Malignancy can present with radiologic findings mimicking other lung diseases.
- Noncaseating granulomas (NCG) are a key feature of sarcoidosis but can also occur in other conditions.
Purpose of the Study:
- To define the radiologic features of sarcoidlike reaction in patients with cancer.
- To investigate the pathogenesis and prognostic significance of this reaction.
Main Methods:
- Review of chest radiographs and CT scans in 10 cancer patients with NCG.
- Correlation with histopathologic findings and clinical data.
Main Results:
- Mediastinal/hilar lymphadenopathy or lung nodules were observed in all patients.
- 80% of specimens showed NCG without tumor; 20% had tumor amidst NCG.
- CT revealed ground-glass attenuation or nodules in parenchymal lung disease.
Conclusions:
- Enlarged lymph nodes and lung nodules in cancer patients may represent sarcoidlike reaction, not metastasis.
- Thorough histopathologic sampling is vital for accurate staging and prognosis.
- NCG in cancer patients suggests sarcoidlike reaction, not necessarily sarcoidosis.