Dhillon Gundip S, Jalal Yema, Mehta Vishisht
Internal Medicine, Mountainview Hospital, Las Vegas, USA.
Interventional Pulmonology, Mountainview Hospital, Las Vegas, USA.
Cureus. 2023 Mar 1;15(3):e35648. doi: 10.7759/cureus.35648. eCollection 2023 Mar.
A 56-year-old male underwent treatment for sarcoma with metastases to the lungs. Follow-up imaging revealed multiple pulmonary nodules and masses with a favorable response on positron emission tomography (PET) scanning showing enlarging mediastinal lymph nodes concerning for progression of the disease. To evaluate the lymphadenopathy, the patient underwent bronchoscopy with endobronchial ultrasound and transbronchial needle aspiration. The lymph nodes were negative for cytology but showed granulomatous inflammation. Granulomatous inflammation is a rare occurrence in patients with concurrent metastatic lesions and is exceedingly rare in cancers that have not originated in the thorax. This case report highlights the clinical significance of sarcoid-like reactions in the mediastinal lymph nodes and the need for further investigation.
一名56岁男性因肉瘤伴肺转移接受治疗。随访影像学检查发现多个肺结节和肿块，正电子发射断层扫描（PET）显示有良好反应，但纵隔淋巴结增大，担心疾病进展。为评估淋巴结病，患者接受了支气管镜检查，包括支气管内超声和经支气管针吸活检。淋巴结细胞学检查为阴性，但显示肉芽肿性炎症。肉芽肿性炎症在并发转移性病变的患者中很少见，在非起源于胸部的癌症中极为罕见。本病例报告强调了纵隔淋巴结中类肉瘤样反应的临床意义以及进一步调查的必要性。
