Sarcoidosis development during induction chemotherapy for lung cancer mimicked progressive disease

We report a rare case of sarcoidosis that developed during induction chemotherapy for primary lung cancer, mimicking progressive disease. A 63-year-old man had an abnormal shadow in the right upper lung, and a bronchoscopic examination revealed a squamous cell carcinoma. Swelling of a pretracheal ly...

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2010-08, Vol.58 (8), p.434-437
Main Authors: Umezu, Hideo, Chida, Masayuki, Inoue, Takashi, Araki, Osamu, Tamura, Motohiko, Tatewaki, Masamitsu, Fukushima, Yasutsugu, Honma, Koichi
Format: Article
Language:English
Subjects:
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Biopsy
Carboplatin - administration & dosage
Carcinoma, Squamous Cell - diagnosis
Carcinoma, Squamous Cell - drug therapy
Carcinoma, Squamous Cell - surgery
Cardiac Surgery
Cardiology
Case Report
Chemotherapy, Adjuvant
Disease Progression
Fluorodeoxyglucose F18
Humans
Lung cancer
Lung Neoplasms - diagnosis
Lung Neoplasms - drug therapy
Lung Neoplasms - surgery
Lymph Node Excision
Lymph Nodes - diagnostic imaging
Lymph Nodes - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Paclitaxel - administration & dosage
Pneumonectomy
Positron-Emission Tomography
Radiopharmaceuticals
Sarcoidosis, Pulmonary - chemically induced
Sarcoidosis, Pulmonary - diagnosis
Surgical Oncology
Thoracic Surgery
Tomography, X-Ray Computed
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Summary:We report a rare case of sarcoidosis that developed during induction chemotherapy for primary lung cancer, mimicking progressive disease. A 63-year-old man had an abnormal shadow in the right upper lung, and a bronchoscopic examination revealed a squamous cell carcinoma. Swelling of a pretracheal lymph node was also noted. Thus, we gave induction chemotherapy consisting of paclitaxel (days 1, 8) + carboplatin (days 1, 8) for two cycles under clinical staging of T2N2M0. After induction chemotherapy, 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) showed positive accumulation of FDG in mediastinal and bilateral hilar lymph nodes that had been negative in a previous FDG-PET examination, which led us to suspect disease progression. Transbronchial lymph node biopsy results showed sarcoid granulomas in the specimens. Following complete resection of the lung cancer, sarcoid granulomas were revealed in both nonneoplastic lung tissue and lymph nodes, which resulted in a diagnosis of lung cancer accompanied with sarcoidosis.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-009-0549-3