Mayama Michinori, Yoshihara Masato, Ukai Mayu, Kondo Shinya, Kishigami Yasuyuki, Oguchi Hidenori
Toyota Memorial Hospital, Department of Obstetrics and Gynecology, Toyota, Japan.
J Obstet Gynaecol Res. 2015 Nov;41(11):1855-8. doi: 10.1111/jog.12829. Epub 2015 Sep 30.
A sarcoid-like reaction is a development of non-caseating granuloma in patients with underlying malignancy and represents a false positive finding on positron emission tomography/computed tomography (PET/CT). A sarcoid-like reaction is a benign condition; therefore, differentiating a sarcoid-like reaction from cancer recurrence is necessary. Only uterine and ovarian cancer related cases have been reported in the gynecological field and to the best of our knowledge, this is the first case of a sarcoid-like reaction in vaginal cancer. A 59-year-old vaginal cancer patient received concurrent chemoradiotherapy and achieved complete remission. Recurrence of vaginal cancer was suspected because of the elevation of serum squamous cell carcinoma antigen level. PET/CT revealed abnormal uptake at the bilateral mediastinal and hilar lymph nodes. A non-caseating granuloma was detected from the biopsy of the swollen lymph nodes. No evidence of cancer recurrence was observed. A sarcoid-like reaction should be considered when evaluating PET/CT in cancer patients to prevent unnecessary treatments.
类肉瘤样反应是指在患有潜在恶性肿瘤的患者中出现非干酪样肉芽肿，这在正电子发射断层扫描/计算机断层扫描（PET/CT）上表现为假阳性结果。类肉瘤样反应是一种良性病症；因此，有必要将类肉瘤样反应与癌症复发区分开来。在妇科领域，仅报道过与子宫癌和卵巢癌相关的病例，据我们所知，这是首例阴道癌类肉瘤样反应病例。一名59岁的阴道癌患者接受了同步放化疗并实现完全缓解。由于血清鳞状细胞癌抗原水平升高，怀疑阴道癌复发。PET/CT显示双侧纵隔和肺门淋巴结有异常摄取。从肿大淋巴结的活检中检测到非干酪样肉芽肿。未观察到癌症复发的证据。在评估癌症患者的PET/CT时应考虑类肉瘤样反应，以避免不必要的治疗。
