Lashari Bilal H, Asai Megumi, Randleman Gissele, Sack Martha, Patel Rajeshkumar
Department of Internal Medicine, Abington Jefferson Health, Abington, PA, USA.
Department of Surgery, Abington Jefferson Health, Abington, PA, USA.
Pulm Med. 2018 Feb 14;2018:5141575. doi: 10.1155/2018/5141575. eCollection 2018.
Noncaseating granulomas are seen surrounding tumors with varying frequency, possibly as part of an immune response to tumor cells. However, data about the association of sarcoid with gynecologic malignancy is sparse. We performed a search of our institutional database for all EBUS-TBNA biopsies conducted within the past five years that revealed granulomatous inflammation. All adult female patients with a history of gynecologic malignancy were included. Patients with a history of sarcoidosis or fungal or mycobacterial infection were excluded. All patients with evidence of malignant cells on TBNA specimen were excluded. Our results revealed 65 patients with histologic diagnosis of a noncaseating granuloma on EBUS-TBNA. Five patients (7.69%) had a history of gynecologic malignancy. Two patients had evidence of PET-positive nodes on surveillance scans, which led directly to the examination. Our findings suggest that distant malignancies may cause granulomatous lymphadenitis, through yet undefined mechanisms. As such, patients with evidence of mediastinal lymphadenopathy could benefit from routine sampling and histologic examination to define the pathology in the correct clinical context.
非干酪样肉芽肿以不同频率出现在肿瘤周围，可能是对肿瘤细胞免疫反应的一部分。然而，关于结节病与妇科恶性肿瘤关联的数据很少。我们在机构数据库中搜索了过去五年内所有显示肉芽肿性炎症的EBUS-TBNA活检病例。纳入所有有妇科恶性肿瘤病史的成年女性患者。排除有结节病、真菌或分枝杆菌感染病史的患者。排除TBNA标本有恶性细胞证据的所有患者。我们的结果显示，65例患者经EBUS-TBNA组织学诊断为非干酪样肉芽肿。5例患者（7.69%）有妇科恶性肿瘤病史。2例患者在监测扫描中有PET阳性淋巴结的证据，这直接导致了此次检查。我们的研究结果表明，远处恶性肿瘤可能通过尚未明确的机制导致肉芽肿性淋巴结炎。因此，有纵隔淋巴结肿大证据的患者可能受益于常规采样和组织学检查，以便在正确的临床背景下明确病理情况。
