East Tennessee State University, Johnson City, TN, USA.
James H. Quillen Veterans Affairs Medical Center, Mountain Home, TN, USA.
J Investig Med High Impact Case Rep. 2020 Jan-Dec;8:2324709620938942. doi: 10.1177/2324709620938942.
Sarcoidosis is a multisystem granulomatous disease commonly involving the lungs and mediastinal lymph nodes with the exact etiology being unclear. The simultaneous presence of malignant disease such as breast cancer and sarcoidosis has been reported. Sarcoidosis preceding a diagnosis of malignancy and that occurring years after treatment of malignant disease has been noted in the past. The presence of sarcoidosis in the setting of malignant disease carries a high risk of misdiagnosis. In this article, we report the case of a 45-year-old female with stage IA invasive ductal carcinoma of left breast that was in remission for 2 years; however, radiological imaging including magnetic resonance imaging of thoracic spine and positron emission tomography-computed tomography scanning were highly suspicious for malignant disease metastasis versus lymphoma with the widespread lymphadenopathy. Multiple tissue biopsies with histopathological evaluation allowed us to definitively exclude malignant disease metastasis and to correctly diagnose her atypical presentation of sarcoidosis.
结节病是一种多系统肉芽肿性疾病，通常累及肺部和纵隔淋巴结，确切病因尚不清楚。有报道称同时存在乳腺癌和结节病等恶性疾病。过去也有恶性疾病诊断前出现结节病和恶性疾病治疗多年后出现结节病的情况。恶性疾病合并结节病存在高度误诊风险。本文报道了一例 45 岁女性，左侧乳腺 IA 期浸润性导管癌，已缓解 2 年；然而，包括胸椎磁共振成像和正电子发射断层扫描-计算机断层扫描在内的影像学检查高度怀疑为恶性疾病转移而非淋巴瘤伴广泛淋巴结病。多份组织活检并进行组织病理学评估使我们能够明确排除恶性疾病转移，并正确诊断出她不典型的结节病表现。
