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Vol.39 No.3 contents | Japanese/English |
- Original Article -
Computed Tomographic Evaluation of Sarcoid-like Reaction in Patients with Lung Cancer
Mayumi Seto1,2, Keiko Kuriyama2, Masahiko Higashiyama3, Shoji Kido2, Hideoki Yokouchi3, Ken Kodama3, Takashi Seto4,5, Takeshi Horai4 and Chikazumi Kuroda21Division of Internal Medicine, Seto Hospital, 2Department of Diagnostic Radiology, 3Department of Thoracic Surgery, 4Fourth Department of Internal Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases, 5Division of Respiratory Diseases, Kumamoto Regional Medical Center
We reviewed computed tomographic scans of five patients of lung cancer with sarcoid-like reaction. Four were men and one was a woman. The ages ranged from 65 to 75. All patients were found to have mediastinal lymph node enlargement, and the presumptive diagnosis was metastatic disease. The histological examination of the resected lymph nodes revealed non-caseating epithelial cell granulomas and no cancer metastasis. In 3 of the 5 patients, superior mediastinal lymph nodes were enlarged, and in 3 of 5, pretracheal mediastinal lymph nodes were enlarged. Ten enlarged mediastinal lymph nodes were seen, and 7 of 10 nodes were measured 10 × 10 mm. Our results show that radiographic patterns do not necessarily indicate metastatic disease. The assumption of metastatic disease can lead to inaccurate staging of the disease and inaccurate treatment and prognosis determination.Analysis of a larger series is needed. Furthermore, in operable cases, a mediastinoscopic biopsy should be performed to adequately exclude metastatic disease.
key words: Sarcoid-like reaction, Lung cancer, Computed tomography
Received: September 25, 1998
Accepted: April 14, 1999
JJLC 39 (3): 289-293, 1999
