Tjan-Heijnen V C, Vlasveld L T, Pernet F P, Pauwels P, De Mulder P H
Department of Medical Oncology, University Hospital Nijmegen, the Netherlands.
Ann Oncol. 1998 Mar;9(3):321-5. doi: 10.1023/a:1008220002148.
A patient with a stage II seminoma of the testis was treated with a routine orchidectomy and irradiation. One and a half years later enlarged mediastinal lymph nodes were noted. Additional staging showed no other abnormalities and a mediastinoscopy was performed. The initial histologic examination confirmed the clinically suspected diagnosis of sarcoidosis. However, additional immunohistochemical analysis unexpectedly demonstrated that there was also a microscopic relapse of the testis tumor. The literature concerning the co-incidence of non-caseating granulomas and testis tumors is reviewed. It is not clear, whether the granulomas indicate the presence of genuine idiopathic sarcoidosis or whether they reflect a sarcoid-like reaction against tumor antigens. The immunopathogenesis of sarcoid formation and its possible biologic significance in obtaining a spontaneous tumor remission is discussed.
一名患有睾丸II期精原细胞瘤的患者接受了常规睾丸切除术和放射治疗。一年半后，发现纵隔淋巴结肿大。进一步分期检查未发现其他异常，并进行了纵隔镜检查。最初的组织学检查证实了临床上疑似的结节病诊断。然而，进一步的免疫组化分析意外地显示，睾丸肿瘤也存在微小复发。本文回顾了有关非干酪样肉芽肿与睾丸肿瘤并存的文献。目前尚不清楚这些肉芽肿是表明存在真正的特发性结节病，还是反映了针对肿瘤抗原的类结节样反应。本文讨论了结节形成的免疫发病机制及其在获得肿瘤自发缓解方面可能的生物学意义。
