Kishino Takayoshi, Okano Keiichi, Ando Yasuhisa, Suto Hironobu, Asano Eisuke, Oshima Minoru, Fujiwara Masao, Usuki Hisashi, Kobara Hideki, Masaki Tsutomu, Ibuki Emi, Kushida Yoshio, Haba Reiji, Suzuki Yasuyuki
Department of Gastroenterological Surgery, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
Department of Gastroenterology and Neurology, Kagawa University, Kagawa, Japan.
Surg Case Rep. 2018 Jun 25;4(1):62. doi: 10.1186/s40792-018-0473-9.
In patients with esophageal cancer, differentiation between lymph node metastasis and lymphadenopathies from sarcoidosis or sarcoid-like reactions of lymph nodes is clinically important. Herein, we report two esophageal cancer cases with lymph node involvement of sarcoid-like reaction or sarcoidosis.
One patient received chemotherapy and the other chemoradiotherapy as initial treatments. In both cases, [F]-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) was performed before and after chemo(radio)therapy. After the treatment, FDG uptake was not detected in the primary tumor, but it was slightly reduced in the hilar and mediastinal lymph nodes in both cases. These non-identical responses to chemo(radio)therapy suggest the presence of sarcoid-like reaction of lymph nodes associated with squamous cell carcinoma of the esophagus. Curative surgical resection was performed as treatment.
These FDG-PET/CT findings may be helpful to distinguish between metastasis and sarcoidosis-associated lymphadenopathy in esophageal cancer.
在食管癌患者中，区分淋巴结转移与结节病或淋巴结类结节样反应所致的淋巴结病变在临床上具有重要意义。在此，我们报告两例伴有类结节样反应或结节病淋巴结受累的食管癌病例。
一名患者接受化疗，另一名患者接受放化疗作为初始治疗。在这两例病例中，化疗（放疗）前后均进行了[F] - 氟脱氧葡萄糖正电子发射断层扫描 - 计算机断层扫描（FDG - PET/CT）。治疗后，原发肿瘤未检测到FDG摄取，但两例病例的肺门和纵隔淋巴结FDG摄取均略有降低。这些对化疗（放疗）的不同反应提示存在与食管鳞状细胞癌相关的淋巴结类结节样反应。作为治疗进行了根治性手术切除。
这些FDG - PET/CT结果可能有助于区分食管癌中的转移和结节病相关的淋巴结病变。
