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

Öz

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

Anahtar Kelimeler

• Sarcoid-like reaction, Sarcoidosis, Granuloma, Lymphadenopathy, Breast cancer

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

Öz

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

Anahtar Kelimeler

• Sarkoid benzeri reaksiyon, Sarkoidoz, Granülom, Lenfadenopati, Meme kanseri

Kaynakça

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