A Case of Sarcoidosis Associated with Esophageal Cancer
Ishiyama, K.; Nomura, T.; Fukushima, N.; Iizawa, H.; Ogata, S.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 45(11): 1649-1652
2018
ISSN/ISBN: 0385-0684 PMID: 30449856 Document Number: 695549
A 67-year-old man was diagnosed with esophageal cancer. Computed tomography(CT)revealed multiple sites of bilateral mediastinal lymph node swelling. Serum levels of soluble interleukin-2 receptor(sIL-2R)were elevated; however, serum levels of angiotensin-converting enzyme(ACE)were normal. Thus, we could not confirm a diagnosis of sarcoidosis. Esophagectomy with neck lymph node dissection was performed. The resected specimen, comprising the mediastinal lymph nodes, showed noncaseating epithelioid cell granuloma; this supported the diagnosis of sarcoidosis. Cases of sarcoidosis associated with esophageal cancer are rare. It is difficult to distinguish between metastasis and sarcoid-like reactions from swollen lymph nodes using preoperative CT or positron emission tomography(PET). It is possible to differentiate lymph node metastasis from its sarcoid reaction it the patient received.