Sarcoid-Like Reactive Lymphadenopathy in Metastatic Synovial Sarcoma

Division

Far West

Hospital

MountainView Hospital

Document Type

Case Report

Publication Date

3-1-2023

Keywords

lymph nodes pathology, noncaseating granuloma, sarcoid like reaction, sarcoma soft tissue, synovial sarcoma

Disciplines

Hemic and Lymphatic Diseases | Internal Medicine | Neoplasms

Abstract

A 56-year-old male underwent treatment for sarcoma with metastases to the lungs. Follow-up imaging revealed multiple pulmonary nodules and masses with a favorable response on positron emission tomography (PET) scanning showing enlarging mediastinal lymph nodes concerning for progression of the disease. To evaluate the lymphadenopathy, the patient underwent bronchoscopy with endobronchial ultrasound and transbronchial needle aspiration. The lymph nodes were negative for cytology but showed granulomatous inflammation. Granulomatous inflammation is a rare occurrence in patients with concurrent metastatic lesions and is exceedingly rare in cancers that have not originated in the thorax. This case report highlights the clinical significance of sarcoid-like reactions in the mediastinal lymph nodes and the need for further investigation.

Publisher or Conference

Cureus

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