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Can a Sarcoid-like Reaction Induced by a T-cell Mediated Immune Response Mimic Breast Cancer Metastasis?

Year 2017, Volume: 3 Issue: 3, 215 - 218, 01.01.2017

Abstract

The condition involving the appearance of epithelioid non-classified granulomas, without signs of systemic sarcoidosis, is called sarcoid-like reaction. These granulomas are basically seen in the tumor or the lymph nodes that drain the tumor, and cannot be distinguished from malignancy by means of imaging techniques such as PET/CT. Such a condition may cause lesions to be considered as metastatic lesions in consequence of a misevaluation, and may lead to mistakes in the diagnosis, staging and treatment of the disease. In this study, a locally advanced breast cancer case, which involved the detection of a sarcoid-like reaction, is presented with the aim of increasing awareness regarding any potential mistakes that might occur during the diagnostic PET/CT processes

References

  • Hunsaker AR, Munden RF, Pugatch RD, Mentzer SJ. Sarcoid like reaction in patients with malignancy. Radiology 1996; 200(1):255–61.
  • Gorton G, Linell F. Malignant tumours and sarcoid reactions in regional lymph nodes. Acta Radiol 1957;47:381-92.
  • Llombart A Jr, Escudero JM. The incidence and significance of epithelioid and sarcoid-like cellular reaction in the stromata of malignant tumours. A morphological and experimental study. Eur J Cancer 1970;6:545-51.
  • Brincker H: Sarcoid reactions in malignant tumours. Cancer Treat Rev 1986;13:147-56.
  • Giunti G, Mancini AM, Fontanili M. Sarcoidosis-like findings in the tributary lymph nodes of breast neoplasms. Arch Ital Anat Istol Patol 1964;38:19-46.
  • Azar HA, Lunardelli C. Collagen nature of asteroid bodies of giant cells in sarcoidosis. Am J Pathol 1969;57:81-9.
  • Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 1999;160(2):736-55.
  • Brincker H, Pedersen NT. Immunohistologic separation of B-cell-positive granulomas from B-cell-negative granulomas in paraffin-embedded tissues with special reference to tumor-related sarcoid reactions. 1991; 99(3):282-90.
  • Cohen PR, Kurzrock R. Sarcoidosis and malignancy. Clin Dermatol 2007;25:326-33.
  • Wolbach SB. A new type of cell inclusion, not parasitic, associated with disseminated granulomatous lesions. J Med Res 1911; 24:243-58.
  • Bush E, Lamonica D, O'Connor T. Sarcoidosis mimicking metastatic Breast cancer. Breast Journal 2011; 17(5): 533- 5.
  • Inoue K, Goto R, Shimomura H, Fukuda H. FDG- PET/CT of sarcoidosis and sarcoid reactions following antineoplastic treatment. Springerplus 2013; 2:113.
  • Maeda J, Ohta M, Hirabayashi H, Matsuda H. False positive accumulation in 18F fluorodeoxyglucose positron emission tomography scan due to sarcoid reaction following induction chemotherapy for lung cancer. Jpn J Thorac Cardiovasc Surg 2005;53:196-8.
  • Okada K, Sasaki M, Nanjo H, Ito M, Takahashi S, Itoi E. Benign lesions in cancer patients: Case 2. Unusual association of osteosarcoma and sarcoidosis. Journal of Clinical Oncology 2005; 23(3):641-3.
  • Bässler R1, Birke F. Histopathology of tumour associated sarcoid-like stromal reaction in breast cancer. Virchows Arch A Pathol Anat Histopathol 1988;412(3):231-9.

T Hücre Aracılı İmmün Yanıtla Oluşan Sarkoid Benzeri Reaksiyon Meme Kanseri Metastazını Taklit Edebilir mi?

Year 2017, Volume: 3 Issue: 3, 215 - 218, 01.01.2017

Abstract

Sistemik sarkoidoz bulguları olmaksızın, epiteloid non-kazeifiye granülomların görülmesi halinde, bu duruma sarkoid benzeri reaksiyon adı verilmektedir. Bu granülomlar esas olarak tümör veya tümörü drene eden lenf nodlarında görülmekte ve PET/BT gibi görüntüleme yöntemleriyle de maligniteden ayırt edilememektedir. Bu durum, lezyonların yanlışlıkla metastaz olarak değerlendirilmesine yol açabilmekte ve hastalığın tanı, evreleme ve tedavisinde ciddi hatalara yol açarak telafisi mümkün olmayan sonuçlar doğurabilmektedir. Bu yüzden bu çalışmada; supraklavikular, paratrakeal ve subkarinal lenf nodu tutulumunun gözlendiği sarkoid reaksiyonlu, lokal ileri evre meme kanseri bir olgu sunulmuş ve PET/BT ile teşhiste oluşabilecek yanılgılar adına farkındalık yaratılmaya çalışılmıştır

References

  • Hunsaker AR, Munden RF, Pugatch RD, Mentzer SJ. Sarcoid like reaction in patients with malignancy. Radiology 1996; 200(1):255–61.
  • Gorton G, Linell F. Malignant tumours and sarcoid reactions in regional lymph nodes. Acta Radiol 1957;47:381-92.
  • Llombart A Jr, Escudero JM. The incidence and significance of epithelioid and sarcoid-like cellular reaction in the stromata of malignant tumours. A morphological and experimental study. Eur J Cancer 1970;6:545-51.
  • Brincker H: Sarcoid reactions in malignant tumours. Cancer Treat Rev 1986;13:147-56.
  • Giunti G, Mancini AM, Fontanili M. Sarcoidosis-like findings in the tributary lymph nodes of breast neoplasms. Arch Ital Anat Istol Patol 1964;38:19-46.
  • Azar HA, Lunardelli C. Collagen nature of asteroid bodies of giant cells in sarcoidosis. Am J Pathol 1969;57:81-9.
  • Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 1999;160(2):736-55.
  • Brincker H, Pedersen NT. Immunohistologic separation of B-cell-positive granulomas from B-cell-negative granulomas in paraffin-embedded tissues with special reference to tumor-related sarcoid reactions. 1991; 99(3):282-90.
  • Cohen PR, Kurzrock R. Sarcoidosis and malignancy. Clin Dermatol 2007;25:326-33.
  • Wolbach SB. A new type of cell inclusion, not parasitic, associated with disseminated granulomatous lesions. J Med Res 1911; 24:243-58.
  • Bush E, Lamonica D, O'Connor T. Sarcoidosis mimicking metastatic Breast cancer. Breast Journal 2011; 17(5): 533- 5.
  • Inoue K, Goto R, Shimomura H, Fukuda H. FDG- PET/CT of sarcoidosis and sarcoid reactions following antineoplastic treatment. Springerplus 2013; 2:113.
  • Maeda J, Ohta M, Hirabayashi H, Matsuda H. False positive accumulation in 18F fluorodeoxyglucose positron emission tomography scan due to sarcoid reaction following induction chemotherapy for lung cancer. Jpn J Thorac Cardiovasc Surg 2005;53:196-8.
  • Okada K, Sasaki M, Nanjo H, Ito M, Takahashi S, Itoi E. Benign lesions in cancer patients: Case 2. Unusual association of osteosarcoma and sarcoidosis. Journal of Clinical Oncology 2005; 23(3):641-3.
  • Bässler R1, Birke F. Histopathology of tumour associated sarcoid-like stromal reaction in breast cancer. Virchows Arch A Pathol Anat Histopathol 1988;412(3):231-9.
There are 15 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Ahmet Ünlü This is me

Önder Kırca This is me

İrfan Öğretmen This is me

Oben Duman This is me

Publication Date January 1, 2017
Published in Issue Year 2017 Volume: 3 Issue: 3

Cite

Vancouver Ünlü A, Kırca Ö, Öğretmen İ, Duman O. T Hücre Aracılı İmmün Yanıtla Oluşan Sarkoid Benzeri Reaksiyon Meme Kanseri Metastazını Taklit Edebilir mi?. Akd Med J. 2017;3(3):215-8.